Genetic damage in exfoliated cells from oral mucosa of individuals exposed to X-rays during panoramic dental radiographies

A Prospective Study of a Custom-Made Eco-Friendly Thyroid Shield: A Breakthrough in Radiation Protection

Background The thyroid gland is the most susceptible organ to radiation during the exposure of teeth because the thyroid area appears to be within the primary beam, and the dose levels are relatively high even after using collimation. This study aims to develop an eco-friendly thyroid shield by reusing lead foils from intra-oral periapical radiographic films and evaluate its effectiveness in intraoral radiography. Methods A total of 16 patients undergoing endodontic procedures who gave written consent to participate in the study were included and divided into four categories: anterior, canine, premolar, and molar. After preparing a thyroid shield by reutilizing the lead foils, its effectiveness was checked and compared with that of a commercially available thyroid collar (CTC) by measuring the equivalent dose at the position of the thyroid gland while taking radiographs for all four categories. Instruments used included lead foils, cardboard, a CTC, a custom-made thyroid shield (CTS), a dosimeter, and X-ray film. Later, they were divided into three groups: Group I (without), Group II (with CTC), and Group III (with CTS). Results During the radiography, the CTS (Group III) reduced the radiation dose at the thyroid level by approximately 89% and was more effective than the CTC (Group II) in dose reduction when size 2 intraoral periapical (IOPA) radiographs were used. Conclusion The results of this study concluded that the CTS, besides its low cost and ease of preparation, is eco-friendly and more effective than the CTC in terms of dose reduction.

Assessing Genotoxicity and Cytotoxicity Induced by X-Ray Exposure From Cone Beam Computed Tomography at Varied Fields of View

INTRODUCTION

The practice of dentistry benefits greatly from cone beam computed tomography (CBCT) and advantages should be prioritized over hazards; even modest doses of X-rays have the potential to have cytotoxic effects, damage DNA through their clastogenic impact, and stimulate the creation of micronuclei along with further nuclear changes.

AIMS AND OBJECTIVES

To assess the genotoxicity and cytotoxicity of X-rays in exfoliated oral mucosal cells from patients who underwent CBCT scans at different fields of view (FOV), and to examine and assess the extent of cytotoxicity and genotoxicity caused by X-rays in oral exfoliated cells of people who were subjected to CBCT at different fields of view (FOV).

MATERIAL AND METHODS

Following CBCT exposure, 66 patients were chosen from the Department of Oral Medicine and Radiology at the SVS Institute of Dental Sciences, Mahbubnagar. Cells from the buccal mucosa were then extracted using the exfoliative cytology method, and the samples were examined under a microscope to look for nuclear and cytological abnormalities.

RESULTS

A paired t-test analysis revealed that mean micronuclei increased significantly in each study group from before to after exposure. It increased in Group I from 93.59 to 96.05, in Group II from 83.27 to 91.86, and in Group III from 86.05 to 97.00. Various test analyses revealed an important relation between exposure status and the presence of karyorrhexis in Group III. There was no association in other groups.

CONCLUSION

The study revealed a significant increase of micronuclei in subjects after exposure to radiation at various FOVs. There was an increased karyorrhexis following radiation exposure in all groups at various FOVs. The significant association between exposure and karyorrhexis in the larger size FOV group was noticed further potentiating the extent of increased damage as the size of FOV is increased.

Oxidative Stress Responses in Obese Individuals Undergoing Bariatric Surgery: Impact on Carcinogenesis

Obesity is a big public health problem that claims several thousand lives every year. Bariatric surgery has arisen as a suitable procedure for treating obesity, particularly morbid obesity. Oxidative stress, genotoxicity, apoptosis, and inflammatory responses are recognized as the most important occurrences in carcinogenesis, as they actively contribute to the multistep process. This study aimed to briefly review the connection between oxidative stress, genotoxicity, apoptosis, and inflammation in obese patients undergoing bariatric surgery, focusing on its impact on carcinogenesis. Regarding oxidative stress, bariatric surgery may inhibit the synthesis of reactive oxygen species. Moreover, a significant reduction in the inflammatory status after weight loss surgery was not observed. Bariatric surgery prevents apoptosis in several tissues, but the maintenance of low body weight for long periods is mandatory for mitigating DNA damage. In conclusion, the association between bariatric surgery and cancer risk is still premature. However, further studies are yet needed to elucidate the real association between bariatric surgery and a reduced risk of cancer.

The use of micronucleus assay in oral mucosa cells as a suitable biomarker in children exposed to environmental mutagens: theoretical concepts, guidelines and future directions

In the last decades, the micronucleus assay has been recognized as a suitable biomarker for monitoring populations exposed to many different occupational factors, lifestyle, environmental conditions, radiation exposure, and deleterious effects of pesticides. The objective of this work is to direct the design of future field studies in the assessment of the risk of children exposed to environmental mutagens, radiation, and pesticides. This review sought available information on the analysis of micronuclei in oral cells in children. A literature search for papers investigating DNA damage, genetic damage, oral cells, buccal cells, genotoxicity, mutagenicity and micronucleus was begun in 2000 and is scheduled to be concluded in May, 2022. Briefly, a search of PubMed, MEDLINE, and Google Scholar for a variety of articles was performed. The results showed that there are still few studies that addressed micronuclei of oral cells in children exposed to the most diverse environmental conditions. Only environmental pollution was associated with damage to the genome of oral cells in children. Therefore, researchers need to be calibrated in cell analysis, standardization of field study protocols and the development of new research in the evaluation of children using the micronucleus test as a tool in child biomonitoring.

Evaluation of micronuclei, cytomorphometric and cytologic changes of the oral mucosa in hookah and cigarette smokers

OBJECTIVE

To analyze the effect of hookah and cigarettes on the oral mucosa of smokers through the use of exfoliative cytology.

STUDY DESIGN

Smear samples were collected by exfoliative cytology from the tongue of 33 hookah smokers, 22 cigarette smokers, and 30 non-smokers. The selected analyses include micronuclei (MN), metanuclear anomalies, epithelial maturation, and cytomorphology (nuclear area [NA], cytoplasmic area [CA], and NA/CA ratio).

RESULTS

The largest differences observed for MN and metanuclear anomalies were between cigarette smokers and the control group (notably 1 MN P = .04; total cells with MN P = .039; total MN P = .042; karyorrhexis and binucleation, P = .0001). The hookah group, compared with the control group, showed the greatest differences for karyolysis (P = .0023), binucleation (P = .0003), and broken egg (P = .008). Significant differences were found between the smokers and the control groups regarding changes in the superficial cell without nucleus, perinuclear halo, vacuolization, color change, mucus, and keratohyalin granules. There was a significant increase in the NA and NA/CA ratio in the smoker groups.

CONCLUSION

This study showed that a combined analysis of exfoliative cytology associated with other diagnostic methods is a useful tool for studying oral carcinogenesis. Hookah and cigarettes showed similar effects in terms of displaying substantial cytogenetic and cytotoxic damage.

Comparative evaluation of mutagenic effects of two cone-beam computed tomography in oral mucosa cells

BACKGROUND

This pilot study aimed to evaluate the mutagenic effects in cells of the oral mucosa after exposure to two different cone beam computed tomography (CBCT).

METHODS

Eighteen adults were submitted to the different CBCT (Carestream CS8100 3D and I-CAT). The cells were collected immediately before the CBCT exposure and 10 days later, when the material was placed on a slide and stained using the Feulgen/Fast Green technique. Microscopic analysis counted micronuclei and other nuclear alterations, which are indicative of cytotoxicity such as pyknosis, karyolysis, karyorrhexis, and binucletion. 2000 cells were analyzed. The statistical analysis was performed with the Wilcoxon Signed-Rank test to compare the frequency of cellular alterations, and the Mann-Whitney U test to compare different CBCTs, both with a significance level of 5%.

RESULTS

There was no statistically significant difference in the micronucleated cell count before and after the exposition to the ionizing radiation from I-CAT (p = .298) and CS8100 3D (p = .203) A significate increase of pyknosis (p < .001), karyolysis (p < .001), karyorrhexis (p < .001), and binucletion (p < .001) were noted on I-CAT CBCT. There was no statistically significant difference in cellular alterations in CS8100 3D CBCT.

CONCLUSION

Despite the increase in micronuclei after exposure, this study indicates that there is no evidence of genotoxicity. On the other hand, the I-CAT CBCT produced cytotoxic effects.

Assessment of cellular damage with cytome assay among environmental/occupational triazole

The use of triazole fungicides is common in Minas Gerais, Brazil. However, the risk arising from excessive and often unprotected exposure can be harmful to farmers. Therefore, we evaluated volunteers, exposed to triazole fungicides for cellular damage caused by this pesticide. In the buccal micronucleus cytome assay (BMCyt), cells were analyzed. Urinary triazoles were analyzed by the Liquid-Liquid Extraction coupled with Gas-chromatography/mass-spectrometry (LLE-GC/MS). Statistical differences were found for all cell types evaluated in residents of rural areas (n = 145). Analysis of variance showed statistical difference in kariolytic and pyknotic cells, between the groups of men and women living in rural areas, with higher incidence in the male group. Likewise, higher concentrations triazoles in urine samples in the male group were observed. Greater cellular damage suggests increases in DNA damage, chromossomal instability and cell deaths. The results showed the urgency of the public management with the implementation of measures to minimize the pesticides exposure.

Cytotoxicity, genotoxicity, and immunohistochemical expression of p53 in the oral mucosal epithelium of adults following cone-beam computed tomography

This study sought to assess the cytotoxicity, genotoxicity, and immunohistochemical (IHC) expression of p53 in the oral mucosal epithelium of adults following cone-beam computed tomography (CBCT). This before-and-after observational study evaluated 30 patients (15 males and 15 females); mean age 35 years, who required CBCT. Exfoliating epithelial cells of the buccal mucosa were collected with a cotton swab immediately before and 10 days after CBCT. Following Papanicolaou staining, genotoxicity was evaluated by the micronucleus assay. The frequencies of pyknosis, karyorrhexis, karyolysis, budding and binucleation as cytotoxicity factors were also recorded. Expression of p53 was evaluated by IHC staining. Data were analyzed by paired samples t-test. Micronucleated cells, pyknosis, karyorrhexis, karyolysis, budding, cytotoxicity, and expression of p53 increased significantly after CBCT. CBCT exerts genotoxic and cytotoxic effects and leads to overexpression of p53 protein in the oral buccal mucosal cells.

Can exposure to panoramic radiographs induce genotoxic effects on the oral epithelium? A systematic review with meta-analysis

OBJECTIVE

To evaluate, through a systematic review (SR) with meta-analysis, the occurrence of genotoxic effects in the oral epithelium after the exposure of patients to panoramic radiographs.

METHODS

An SR was performed with the PICOS (Population, Intervention, Comparison, Outcome, and Study design) strategy, aiming to answer the following question: "Can panoramic radiographs induce genotoxic effects on the oral epithelium?" The study was registered in the PROSPERO (International prospective register of systematic reviews) platform. A systematic search was performed in the following electronic databases: PubMed (including MedLine), Scopus, Embase, LILACS, Medline EbscoHost, and Google Scholar. Treatment effects were defined as standardized mean difference (SMD), and 95% confidence intervals (CI) were established. The Joanna Briggs Institute questionnaire for observational studies was applied to assess the risk of bias. The GRADE tool was used to assess the quality of evidence of the SR.

RESULTS

A total of 251 potentially relevant studies were selected through the search strategy. After screening titles and abstracts, 11 full-text manuscripts were assessed for eligibility and nine observational studies were included in the meta-analysis. The present study showed an increase in micronuclei after the exposure (SMD = 0.21, 95% CI, 0.03 to 0.28, p = 0.02), with a Tau²index = 0.00, Chi² = 2.35, and p-value = 0.97. Therefore, the articles selected were considered homogeneous and the I² of 0% indicated low heterogeneity.

CONCLUSION

According to the studies analysed, although the quality of evidence was considered low, panoramic radiographs can cause genotoxic damage in the oral epithelium but with a small effect size.

Genotoxicity and cytotoxicity of cone beam computed tomography in children

BACKGROUND

Dental radiographs are essential tools for diagnosis. However, there are significant concerns about the dangerous effect of radiation especially on children. The aim of this study was to evaluate genotoxicity and cytotoxicity in the exfoliated cells of buccal mucosa of children subjected to Cone Beam Computed Tomography (CBCT).

METHODS

The study included 18 healthy children aged (9-12 years) who were exposed to CBCT. All CBCT scans were performed with the i-CAT CBCT. Exfoliated buccal cells were scraped from the left and right cheek immediately before the exposure, after 10 ± 2 days, and after 1 month. Cells were stained using Feulgen/fast green stain and examined under light microscopy. Genotoxicity (Micronuclei) and cytotoxicity (condensed chromatin, karyorrhexis, pyknosis, and karyolysis) were scored. Statistical analysis was performed using the McNemar test, Wilcoxon Signed-Rank test, and Mann-Whitney U test at a significance level of p < 0.05.

RESULTS

There were statistically significant differences in the mean percentages of micronuclei, condensed chromatin, karyorrhexis, pyknosis, and karyolysis before and 10 ± 2 days after the CBCT scan (p < 0.05). There were no statistically significant differences in the frequency of micronuclei, condensed chromatin, karyorrhexis, or pyknosis before and 1 month after the exposure (p > 0.05) except for karyolysis (p < 0.05).

CONCLUSIONS

CBCT may induce genotoxicity and cytotoxicity in buccal mucosa cells of children. Therefore, CBCT should not be prescribed unless necessary as it cannot be considered a risk-free procedure.

Radiobiological risks following dentomaxillofacial imaging: should we be concerned?

OBJECTIVES

This review aimed to present studies that prospectively investigated biological effects in patients following diagnostic dentomaxillofacial radiology (DMFR).

METHODS

Literature was systematically searched to retrieve all studies assessing radiobiological effects of using X-ray imaging in the dentomaxillofacial area, with reference to radiobiological outcomes for other imaging modalities and fields.

RESULTS

There is a lot of variability in the reported radiobiological assessment methods and radiation dose measures, making comparisons of radiobiological studies challenging. Most radiological DMFR studies are focusing on genotoxicity and cytotoxicity, data for 2D dentomaxillofacial radiographs, albeit with some methodological weakness biasing the results. For CBCT, available evidence is limited and few studies include comparative data on both adults and children.

CONCLUSIONS

In the future, one will have to strive towards patient-specific measures by considering age, gender and other individual radiation sensitivity-related factors. Ultimately, future radioprotection strategies should build further on the concept of personalized medicine, with patient-specific optimization of the imaging protocol, based on radiobiological variables.

In silico, in vitro, and ex vivo studies of the toxicological and pharmacological properties of the flavonoid 5,7-dihydroxy-3,8,4'-trimethoxy

Phytochemical studies of the species Pavonia glazioviana were performed. Quercetin, kaempferol, acacetin, and trimethoxylated flavonoid compounds (which present biological activity) were isolated. We aimed to evaluate the in silico, in vitro, and ex vivo toxicity of flavonoid 5,7-dihydroxy-3,8,4'-trimethoxy (Pg-1) obtained from P. glazioviana through chemical structure analyses, toxicity assessment, and predictive bioactive properties, using human samples in in vitro tests. In silico analysis suggested that Pg-1 presents a good absorption index for penetrating biological membranes (for oral bioavailability), while also suggesting potential antimutagenic, anticarcinogenic, antioxidant, antineoplastic, anti-inflammatory, anti-hemorrhagic, and apoptosis agonist bioactivities. Assessment of hemolytic and genotoxic effects revealed low hemolysis rates in red blood cells with no cellular toxicity in oral mucosa cells. The reduced cytotoxic activity suggested the safety of the concentrations used (500-1000 µg/mL), and demonstrated the varied interactions of Pg-1 with the analyzed cells. The data obtained in the present study suggested potential therapeutic application, and the non-toxic profile indicated viability for future studies.

E-cig might cause cell damage of oral mucosa

OBJECTIVE

The aim of this study was to investigate cytogenetic and cytotoxic damage through the evaluation of micronuclei (MN) and metanuclear anomalies in the oral mucosa of electronic cigarette (e-cig) users.

STUDY DESIGN

The patients were recruited into 4 groups: e-cig users, smokers, former smokers, and nonsmokers (control). The samples were collected by means of exfoliative cytology of the lateral region of the tongue and the floor of the mouth. The smears obtained were fixed and stained by the Feulgen method for investigation of MN and metanuclear anomalies.

RESULTS

A significant difference was observed for MN frequency only between the smoker and control groups. As for metanuclear anomalies, significant differences were observed: karyolysis between: smokers and control, e-cig and control, as well as former smokers; karyorrhexis: between smoker and control; binucleation: between e-cig and former smoker, as well as control; broken eggs: between e-cig and all other groups; nuclear bud: between e-cig and former smokers, as well as control.

CONCLUSIONS

E-cig and alcohol users presented genotoxicity and cytotoxicity in the oral mucosa cells. The use of e-cigs and alcohol by former smokers can cause more damage to the cells of the oral mucosa compared to those who have not used e-cigs.

Effects of low-dose irradiation on human osteoblasts and periodontal ligament cells

OBJECTIVE

To investigate the effects of dental x-ray on proliferation and mineralization in human primary osteoblasts as well as on proliferation and apoptotic potential in human periodontal ligament (PDL) cells.

DESIGN

Primary osteoblasts and PDL cells were irradiated with various doses of periapical radiography by repeated exposures and further incubated for 1, 3 or 7 days. Cell proliferation was assayed by BrdU incorporation. The effect of dental x-ray on mineralization in osteoblasts either before or after x-ray exposures was determined by Alizarin red staining. Both mRNA and protein expressions of BCL-2, an anti-apoptotic gene, and BAX, a pro-apoptotic gene, in PDL cells were analyzed by RT-qPCR and immunoblotting analysis, respectively.

RESULTS

Neither the proliferative nor the mineralization ability of irradiated osteoblasts was different from that of non-irradiated osteoblasts at any doses or time points. By contrast, there was a significant decrease in the proliferation of PDL cells on day 3 after repeated exposures to dental x-ray for 20 times (P < 0.05), whereas the ratio of BCL-2 to BAX mRNA and protein expressions in these irradiated PDL cells was significantly increased (P < 0.05).

CONCLUSIONS

Upon multiple exposures to dental x-ray used in intraoral radiography up to 20 times, there is no effect on the proliferation or the mineralization of osteoblasts, whereas the proliferative and apoptotic potentials of PDL cells are transiently decreased.

A comprehensive review of the literature on the biological effects from dental X-ray exposures

PURPOSE

Routine dental X-rays are among the most common sources of ionizing radiation exposure for healthy individuals globally, with 300 examinations/1000 individuals/year as documented by the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) global survey of medical radiation usage and exposure. Furthermore, in the United States of America, an increased use of dental radiography is evident. However, with the shift from using film to digital image receptors, the dose of radiation per routine examination has decreased. Despite this, there remains public concern of dental X-rays. This continuing concern highlights the need to review the literature on biological and health effects related to exposure, from dental X-rays.

MATERIAL AND METHODS

This report presents studies investigating biological and health effects related to exposures using dental X-rays in patients and provides a critical evaluation. Relevant studies specific to dental X-rays are reviewed from 1970 and onward with the bulk data in this field resulting from epidemiological and biomonitoring studies.

RESULTS

While, most epidemiological studies suggest a possible correlation between head/neck related tumors and exposure to dental X-rays, evidence for causation is lacking. Biomonitoring studies suggest that exposure to low-level radiation such as that of dental radiography may not be a factor in inducing long-term chromosomal damage, but may result in localized cytotoxicity in the irradiated region of the mouth, with no long-term harm.

CONCLUSIONS

In general, the total number of studies is low and the majority of the data has been generated from poorly designed experiments. This review will highlight shortcomings that could influence outcomes and provide a more balanced interpretation that could impact the public perception and the level of public concern on the health effects resulting from dental X-rays.

GENOTOXICIDADE E CITOTOXICIDADE DOS RAIOS X EM CRIANÇAS SUBMETIDAS À RADIOGRAFIA PANORÂMICA

RESUMO Objetivo: Analisar a genotoxicidade e a citotoxicidade produzidas por raios X no epitélio da mucosa oral de crianças durante a obtenção da radiografia panorâmica. Métodos: A amostra foi constituída por 30 crianças saudáveis, sendo 19 do sexo feminino e 11 do masculino, com faixa etária de 4 a 10 anos (média de 7 anos de idade). As células epiteliais da mucosa oral foram coletadas por meio de citologia esfoliativa em base líquida imediatamente antes e após sete dias da obtenção da radiografia panorâmica. Os esfregaços foram processados e corados utilizando a técnica de Feulgen Rossenbeck modificada. Foram analisadas e quantificadas projeções nucleares dos tipos bud e broken egg, alterações genotóxicas na forma de micronúcleo e alterações citotóxicas dos tipos picnose, cariólise e cariorrexe. Resultados: A frequência de picnose, bud e broken egg foi significativamente maior após a exposição aos raios X (p<0,05), porém não houve diferença estatisticamente significante em relação ao sexo, bem como nas demais alterações estudadas. Conclusões: A exposição aos raios X emitidos durante a obtenção da radiografia panorâmica pode induzir à morte celular no epitélio da mucosa oral de crianças. Não foi encontrado indício significativo de efeito genotóxico.

Buccal mucosa micronuclei counts in relation to exposure to low dose-rate radiation from the Chornobyl nuclear accident and other medical and occupational radiation exposures

BACKGROUND

Ionizing radiation is a well-known carcinogen. Chromosome aberrations, and in particular micronuclei represent an early biological predictor of cancer risk. There are well-documented associations of micronuclei with ionizing radiation dose in some radiation-exposed groups, although not all. That associations are not seen in all radiation-exposed groups may be because cells with micronuclei will not generally pass through mitosis, so that radiation-induced micronuclei decay, generally within a few years after exposure.

METHODS

Buccal samples from a group of 111 male workers in Ukraine exposed to ionizing radiation during the cleanup activities at the Chornobyl nuclear power plant were studied. Samples were taken between 12 and 18 years after their last radiation exposure from the Chornobyl cleanup. The frequency of binucleated micronuclei was analyzed in relation to estimated bone marrow dose from the cleanup activities along with a number of environmental/occupational risk factors using Poisson regression adjusted for overdispersion.

RESULTS

Among the 105 persons without a previous cancer diagnosis, the mean Chornobyl-related dose was 59.5 mSv (range 0-748.4 mSv). There was a borderline significant increase in micronuclei frequency among those reporting work as an industrial radiographer compared with all others, with a relative risk of 6.19 (95% CI 0.90, 31.08, 2-sided p = 0.0729), although this was based on a single person. There was a borderline significant positive radiation dose response for micronuclei frequency with increase in micronuclei per 1000 scored cells per Gy of 3.03 (95% CI -0.78, 7.65, 2-sided p = 0.1170), and a borderline significant reduction of excess relative MN prevalence with increasing time since last exposure (p = 0.0949). There was a significant (p = 0.0388) reduction in MN prevalence associated with bone X-ray exposure, but no significant trend (p = 0.3845) of MN prevalence with numbers of bone X-ray procedures.

CONCLUSIONS

There are indications of increasing trends of micronuclei prevalence with Chornobyl-cleanup-associated dose, and indications of reduction in radiation-associated excess prevalence of micronuclei with time after exposure. There are also indications of substantially increased micronuclei associated with work as an industrial radiographer. This analysis adds to the understanding of the long-term effects of low-dose radiation exposures on relevant cellular structures and methods appropriate for long-term radiation biodosimetry.

Micronuclei and other nuclear anomalies in buccal epithelial cells of children with chronic kidney disease

The objective of this study was to reveal the likely genomic instability in children with chronic kidney disease (CKD) using micronucleus (MN) assay on buccal epithelial cells (BEC). We investigated the frequencies of micronuclei and other nuclear anomalies, such as nuclear buds, binucleated cells, condensed chromatin, and karyorrhectic and pyknotic cells in BEC. Children with CKD were grouped as follows: children in the pre-dialysis (PreD) stage (N=17), children on regular haemodialysis (HD) (N=14), and children who have undergone transplantation (Tx) (N=17). As a control group, twenty age- and gender-matched healthy children were selected. The MN frequency in BEC of all groups of children with CKD was significantly elevated (5- to 7-fold) as compared to the control group (p<0.001). In contrast, the frequencies of nuclear buds were not significantly higher in the study groups compared to the control group. The frequencies of binucleated cells and condensed chromatin cells were significantly higher in all subgroups of children with CKD relative to the control group (p<0.001). Our results show that the BEC of pediatric PreD, HD, and Tx patients with CKD display increased cytogenetic, cytokinetic, and cytotoxic effects. They also point to the sensitivity and usefulness of the BEC MN assay in the assessment of genetic susceptibility of patients with CKD.

Genotoxic effects of X-rays in buccal mucosal cells in children subjected to dental radiographs

Objectives/Aims

Bitewing and digital dental panoramic radiographs have become important adjuvants for successful dental practice in pediatric dentistry. Both methods lead to genetic changes in the oral buccal epithelium that have not yet been satisfactorily explored. The aim of the present study was to evaluate the genotoxic effects induced by X-ray radiation from bitewing and panoramic dental radiography in exfoliated buccal epithelial cells of children, using the Buccal Micronucleus Cytome assay.

Materials and Methods

Children (n=40) who met the inclusion criteria and provided signed informed consent were included in the study. Children were selected for undergoing bitewing radiographs (group 1; n=20) or digital dental panoramic radiographs (group 2; n=20). Exfoliated buccal mucosal cells were obtained by scraping the right/left buccal mucosa with a wooden spatula immediately before the X-ray exposure and 10±2 days after exposure.

Results

The frequency of micronuclei increases significantly post exposure to both bitewing and digital dental panoramic radiography in children, but the frequency was higher in bitewing radiographs.

Conclusion

It was concluded that the frequency of micronuclei increases post exposure to both bitewing and digital panoramic radiographs. Increased radiation exposure results in an increase in micronuclei frequency.

Effects of immunosuppressive drugs on oral mucosa in patients with Behçet's disease: cytomorphological and cytopathological assessment

BACKGROUND/AIM

The aim of this study was to investigate cytomorphological and cytopathological changes in oral exfoliated smears collected from immunosuppressed patients with Behçet's disease (BD) using stereological methods.

MATERIALS AND METHODS

For cytomorphometric analysis, mucosal cell smears were obtained from the buccal mucosa and the floor of the mouths of BD patients treated with immunosuppressive drugs and from healthy volunteers. All mucosal smears from the patients and the healthy volunteers were stained using the Papanicolaou method and examined cytopathologically under light microscopy and cytomorphologically via the stereological nucleator method.

RESULTS

The cytomorphological analysis revealed 3 types of mucosal cells, with numbers of particularly pink cells lower in the aphthous areas of the patients with BD compared to the healthy controls (P < 0.05). The nuclear volumes (NVs) and cytoplasmic volume (CVs) were significantly higher in the BD patients (P < 0.05), but the NV/CV ratio was higher only in the drug-use patient groups (P > 0.05). There was lower apoptotic activity in the nondrug-use patients with BD and in the immunosuppressive-taking BD patients.

CONCLUSION

The findings suggest that quantifiably morphological and morphometric changes in oral mucosa can be detected by stereological techniques. Changes in these parameters may indicate malignant transformation in the oral mucosa.

DNA damage in buccal mucosa cells of pre-school children exposed to high levels of urban air pollutants

Air pollution has been recognized as a human carcinogen. Children living in urban areas are a high-risk group, because genetic damage occurring early in life is considered able to increase the risk of carcinogenesis in adulthood. This study aimed to investigate micronuclei (MN) frequency, as a biomarker of DNA damage, in exfoliated buccal cells of pre-school children living in a town with high levels of air pollution. A sample of healthy 3-6-year-old children living in Brescia, Northern Italy, was investigated. A sample of the children's buccal mucosa cells was collected during the winter months in 2012 and 2013. DNA damage was investigated using the MN test. Children's exposure to urban air pollution was evaluated by means of a questionnaire filled in by their parents that included items on various possible sources of indoor and outdoor pollution, and the concentration of fine particulate matter (PM10, PM2.5) and NO2 in the 1-3 weeks preceding biological sample collection. 181 children (mean age ± SD: 4.3 ± 0.9 years) were investigated. The mean ± SD MN frequency was 0.29 ± 0.13%. A weak, though statistically significant, association of MN with concentration of air pollutants (PM10, PM2.5 and NO2) was found, whereas no association was apparent between MN frequency and the indoor and outdoor exposure variables investigated via the questionnaire. This study showed a high MN frequency in children living in a town with heavy air pollution in winter, higher than usually found among children living in areas with low or medium-high levels of air pollution.

Mutagenicity and cytotoxicity in patients submitted to ionizing radiation

OBJECTIVES

To evaluate and compare mutagenicity (micronucleus) and cytotoxicity (karyorrhexis, pyknosis, and karyolysis) in exfoliated buccal mucosa cells of children following cone beam computed tomography (CBCT) or conventional radiograph exposure necessary for orthodontic planning.

MATERIALS AND METHODS

A total of 49 healthy children were submitted to CBCT or a conventional orthodontic radiographic protocol; they were divided into two groups based on exam: CBCT (n  =  24) and Radiographic Set (n  =  25) groups. The micronucleus test in the exfoliated buccal mucosa cells was applied.

RESULTS

There was not a statistically significant difference (P > .05) found between the number of micronucleated buccal mucosa cells (MNC) before and after exposure to radiation in either group, showing that neither group experienced a mutagenic effect. However, radiation did cause other nuclear alterations closely related to cytotoxicity, including karyorrhexis, pyknosis, and karyolysis, in both groups (P < .05). The CBCT group presented a greater increase in cell death than was noted in the Radiographic Set group (P < .044).

CONCLUSION

According to the micronucleus test, mutagenicity was not induced by the CBCT or the conventional radiographs, but cytotoxicity was verified after these exams, especially after CBCT. That might have happened once the CBCT group received a greater radiation dose than the Radiographic Set group as a result of the protocols used in orthodontic planning for this study.

Cytogenetic biomonitoring in oral mucosa cells following dental X-ray

OBJECTIVES

In the past decades, X-rays have been used widely for diagnosis in dentistry. However, it is well known that ionizing radiation causes damage (including single- and double-strand breaks) to deoxyribonucleic acid (DNA) and DNA-protein crosslinks, and induces cellular death. Therefore, outlining the cytogenetic effects induced by X-ray is necessary to identify the degree of cancer risk and minimize potential risks to patients and clinicians. To date, a variety of assays have been proposed in cytogenetic biomonitoring studies, including those that assess metaphase chromosomal aberrations and sister chromatid exchanges, and micronucleus and single-cell gel (comet) assay.

METHODS

Cytogenetic biomonitoring studies focusing on oral mucosa cells in individuals exposed to dental X-ray were reviewed.

RESULTS

Dental X-ray can induce DNA damage and cytotoxicity in oral mucosa cells.

CONCLUSION

These results will contribute to a better understanding of X-ray-induced effects upon the cellular system in individuals continually exposed to known genotoxic/cytotoxic agents.

Formation of micronuclei and other nuclear anomalies in exfoliated nasal and oral cells: results of a human study with workers in a power plant processing poultry litter

Handling of chicken litter leads to exposure to toxic gases, endotoxins and airborne microorganisms. Aim of this study was to investigate if this results in acute cytotoxicity and to damage of the genetic material which is involved in the etiology of various diseases including cancer. Nuclear anomalies which reflect genotoxic and cytotoxic effects were monitored in exfoliated buccal and nasal cells which were collected from workers (n = 25) of a power plant which processes chicken manure and from controls (n = 21). Furthermore, biochemical parameters of the redox status (malondialdehyde, oxLDL and TEAC) and C-reactive protein (CRP) in plasma and the concentrations of toxic gases and endotoxins in the air were determined. No increase of anomalies which reflect chromosomal damage (micronuclei, binucleates, nuclear buds) but significantly higher rates of nuclear aberrations which are indicative for cytotoxicity (karyolysis, karyorrhexis, condensed chromatin) were found in the workers. These effects were in nasal cells more pronounced as in buccal cells. MDA, oxLDL and CRC levels were in both study groups similar. Chemical analyses show that the workers are exposed to high concentrations of NO and endotoxins, while the levels of NO2, NH3 and H2S were below the MAK levels. Taken together, the results show that anomalies that are due to cytotoxicity are increased in the workers and suggest that the exposure may lead to inflammations in the respiratory tract. However, the lack of induction of anomalies that reflect chromosomal damage indicate that no health effects will take place which are due to instability of the genetic material.

Cytogenetic biomonitoring in children submitting to a complete set of radiographs for orthodontic planning

OBJECTIVES

To evaluate the DNA damage (micronucleus) and cellular death (pyknosis, karyolysis, and karyorrhexis) in exfoliated buccal mucosa cells from children undergoing orthodontic radiographs.

MATERIALS AND METHODS

A total of 25 healthy children undergoing orthodontic therapy partook in a complete set of orthodontic radiographs (lateral cephalographic, posteroanterior cephalographic, panoramic, full periapical exam, and bitewing). The micronucleus test in the buccal exfoliated cells was applied. The paired-samples t-test and the Wilcoxon test were used to compare the frequencies of alterations before and after X-ray exposure.

RESULTS

We found no statistically significant differences (P > .05) between micronucleated buccal mucosa cells before and after exposure to radiation. However, radiation did cause other nuclear alterations closely related to cytotoxicity (P  =  .007).

CONCLUSION

According to the micronucleus test, the complete set of radiographs requested in the orthodontic planning may not be a factor that induces chromosomal damage, but it is able to promote cytotoxicity.

Mutagenicity and cytotoxicity assessment in patients undergoing orthodontic radiographs

OBJECTIVES

The aim of the present study was to evaluate DNA damage (micronucleus) and cellular death (pyknosis, karyolysis and karyorrhexis) in exfoliated buccal mucosa cells from individuals following radiography.

METHODS

Lateral and frontal cephalometric X-ray and panoramic dental X-rays were taken of a total of 18 healthy patients (6 male and 12 female) referred for orthodontic therapy. Exfoliated oral mucosa cells were collected immediately before X-ray exposure and after 10 days.

RESULTS

The results revealed no statistically significant difference (P > 0.05) in the frequency micronucleated oral mucosa cells after X-ray exposure. However, X-ray was able to increase other nuclear alterations closely related to cytotoxicity, such as karyorrhexis, pyknosis and karyolysis.

CONCLUSIONS

Data indicated that exposure to certain radiography may not be a factor in inducing chromosomal damage, but it does promote cytotoxicity.

Biomonitoring of DNA damage and cytotoxicity in individuals exposed to cone beam computed tomography

OBJECTIVES

The aim of the present study was to evaluate DNA damage (micronucleus) and cellular death (pyknosis, karyolysis and karyorrhexis) in exfoliated buccal mucosa cells from adults following cone beam CT exposure.

METHODS

A total of 19 healthy adults (10 men and 9 women) submitted to cone beam CT were included.

RESULTS

No significant statistically differences (P > 0.05) in micronucleus frequency were seen before and after cone beam CT exposure. In contrast, the tomography was able to increase other nuclear alterations closely related to cytotoxicity such as karyorrhexis, pyknosis and karyolysis (P < 0.05).

CONCLUSION

In summary, these data indicate that cone beam CT may not be a factor that induces chromosomal damage, but it is able to promote cytotoxicity.

Elevated blood lead levels and cytogenetic markers in buccal epithelial cells of painters in India: genotoxicity in painters exposed to lead containing paints

BACKGROUND, AIM, AND SCOPE

Lead, a major contaminant, is highly used in paint manufacturing due to its anticorrosive properties. Recent reports indicated high lead content among Indian paints used for commercial purposes. Painters are continuously exposed to these lead containing paints during painting of both commercial as well as residential buildings. Lead is well-known for its genotoxicty in occupational workers; however, in Indian painters the genotoxic effects of lead have not been reported to date. Therefore we aimed to study the genotoxic end points in painters due to their long-term exposure to these high lead-containing Indian paints.

MATERIALS AND METHODS

Study group selection was made after a questionnaire administration, which included questions about lifestyle and medical history to exclude exposure to the other potential sources of genotoxics. Blood and buccal cell samples were obtained from 30 male painters and from a similar number of age-matched controls of same location with no occupational exposure to lead. Blood lead levels (Pb-B) were measured in painters and controls. Micronucleus (MN) frequencies and nuclear changes, i.e., karyorrhexis, karyolysis, broken egg, and binucleated, were investigated in buccal epithelial cells.

RESULTS

Painters had significantly (P < 0.01) greater lead levels in blood than the control group. MN frequencies and nuclear changes in buccal epithelial cells were also significantly (P < 0.01) elevated in painters as compared with control subjects. Regression analysis also revealed significant (P < 0.01) association of Pb-B with all the genotoxic endpoints in painters. Cytogenetic damage was significantly associated with Pb-B as no other co-founding factors (smoking, alcohols) showed significant difference between both groups.

DISCUSSION

Lead is widely used in paints which may serve as potential source of exposure among painters due to their long-term engagement with paints. Our results clearly demonstrated genotoxicity among the exposed population as evident from increase micronucleus frequencies, frequent nuclear changes, and apoptosis. Many studies had previously related nuclear change events in buccal epithelial cells with the progression of different carcinomas. Furthermore in-depth investigations with larger sample size are needed to provide evidence to this effect.

CONCLUSIONS

Here, we report cytogenetic toxicity to the exposed population by the high lead containing paints from India for the first time. Frequent, high and unregulated use of lead in paints may cause genetic mutation and may accelerate cytogenetic damage which may further lead to different carcinomas in painters. These findings need to be considered and necessary steps should be taken to protect the occupational workers engaged with these high lead-containing paints.

RECOMMENDATIONS

The use of lead in paints is completely unregulated in India and routine surveillance of paints for lead content is still lacking. These paints are readily available in markets and are also used in other products (jewelry, miniblinds) which could be exported to other countries including United States and Europe. Serious consideration should be given to the inclusion of regulations and bans on the use of lead in paints. Moreover, attention should also be paid towards the use of various protective measures (face-masks, hand gloves, and separate clothes) by the workers as safe work practices during working periods.

Assessment of genetic damage in buccal epithelium cells of painters: micronucleus, nuclear changes, and repair index

The micronucleus (MN) assay in exfoliated buccal cells is a useful and minimally invasive method for monitoring genetic damage in humans exposed to occupational and environmental agents. The MN test is used as an indicator of genotoxic exposition, since it is associated with chromosome aberrations. An increased mutation rate in oral squamous cells, which is indicated by an increased MN frequency, is also related to the development of oral mucosa diseases, such as carcinomas. We evaluated MN frequencies and other nuclear changes (NCs), karyorrhexis (KR), karyolysis (KL), broken egg (BE), and binucleus in buccal mucosa cells of 60 painters (30 smokers and 30 nonsmokers) and 60 healthy control subjects (30 smoker and 30 nonsmoker). Microscopic observation of 3000 cells per individual was performed in both painters and control subjects. In the control group and the exposed group, for each person repair index (RI) was calculated via the following formula: (KR + KL)/(BE + MN). The results showed a statistically significant increase in the frequency of MN in buccal epithelial cells of the exposed group compared with the control group (p < 0.05). Smokers and nonsmokers differed with respect to the incidence of MN and NCs in all groups. In painters, RI was less than that in the control group. There was a significant difference between painters and the control group (p < 0.01) for RI. We believe that determination of RI in addition to NCs and the MN will present a new approach to genotoxicity studies of a population.

Cellular death but not genetic damage in oral mucosa cells after exposure to digital lateral radiography

The aim of the present study was to evaluate DNA damage (micronucleus) and cellular death (pyknosis, karyolysis, and karyorrhexis) in exfoliated buccal mucosa cells from individuals following digital lateral radiography. A total of 30 healthy patients (15 men and 15 women) indicated to the orthodontic therapy were submitted to digital lateral X-ray. Exfoliated oral mucosa cells were collected immediately before the X-ray exposure and after 10 days. The results pointed out no significant statistically differences (p > 0.05) of micronucleated oral mucosa cells. On the other hand, X-ray was able to increase other nuclear alterations closely related to cytotoxicity such as karyorrhexis, pyknosis, and karyolysis. In summary, these data indicate that exposure to digital lateral radiography may not be a factor that induced chromosomal damage, but it is able to promote cytotoxicity.

Cytogenetic biomonitoring in patients exposed to dental X-rays: comparison between adults and children

OBJECTIVES

The aim of the present study was to comparatively evaluate the DNA damage (micronucleus) and cellular death (pyknosis, karyolysis and karyorrhexis) of exfoliated buccal mucosa cells from children and adults following dental X-ray exposure.

METHODS

A total of 17 adults and 17 children submitted to panoramic dental radiography were included in this study.

RESULTS

The results indicated no statistically significant differences (P > 0.05) in children's micronucleated oral mucosa cells before and after dental X-ray exposure. In the same way, no mutagenic effects were observed in adults following X-ray exposure. On the other hand, X-rays increased other nuclear alterations closely related to cytotoxicity such as karyorrhexis, pyknosis and karyolysis in both groups. The comparative analysis between children and adults demonstrated no statistically significant differences in micronucleus frequency or cytotoxicity (P > 0.05).

CONCLUSIONS

In summary, these data indicate that dental paroramic radiography may not be a factor that induces chromosomal damage, but it is able to promote cytotoxicity. It seems that children are not more susceptible to the noxious activities induced by X-rays when compared with adults.

Genotoxic effects of X-rays on keratinized mucosa cells during panoramic dental radiography

OBJECTIVES

The aim of this study was to evaluate the genotoxic effects of X-rays on epithelial gingival cells during panoramic dental radiography using a differentiated protocol for the micronucleus test.

METHODS

40 healthy individuals who underwent this procedure for diagnostic purposes on request from their dentists agreed to participate in this study. All of them answered a questionnaire before the examination. Epithelial gingival cells were obtained from the keratinized mucosa of the upper dental arcade by gentle scraping with a cervical brush immediately before exposure and 10 days later. Cytological preparations were stained according to the Feulgen-Rossenbeck reaction, counterstained with fast green 1% for 1 min and analysed under a light microscope. Micronuclei, nuclear projections (broken eggs) and degenerative nuclear alterations (pyknosis, karyolysis, karyorrhexis and condensed chromatin) were scored.

RESULTS

The frequency of micronuclei was significantly higher after exposure (P < 0.05), as were the frequencies of nuclear alterations indicative of apoptosis (P < 0.001).

CONCLUSIONS

These results indicate that X-ray radiation emitted during panoramic dental radiography induces a genotoxic effect on epithelial gingival cells that increases the frequency of chromosomal damage and nuclear alterations indicative of apoptosis.

Cytogenetic biomonitoring of oral mucosa cells from adults exposed to dental X-rays

PURPOSE

Although it has been clearly demonstrated that X-rays play a key role in diagnosing medical and dental problems, this type of ionizing radiation is also able to induce noxious activities, such as genetic damage. The aim of the present study was to evaluate DNA damage (micronucleus) and cellular death in exfoliated buccal mucosa cells from healthy individuals (smokers and nonsmokers) following dental X-ray exposure.

MATERIAL AND METHODS

A total of 39 healthy people who had submitted to panoramic dental radiography were included in the study: 9 smokers and 30 nonsmokers.

RESULTS

The results indicated no significant statistically differences (P>0.05) in micronucleated oral mucosa cells before and after dental X-ray exposure. On the other hand, X-ray exposure did increase other nuclear alterations closely related to cytotoxicity, such as karyorrhexis, pyknosis, and karyolysis. It seems that cigarette smoke did not affect X-ray outcomes induced in buccal cells.

CONCLUSION

These data indicate that dental panoramic radiography may not induce chromosomal damage, but it is able to promote cytotoxicity. Because cellular death is considered a prime mechanism in nongenotoxic mechanisms of carcinogenesis, dental X-ray should be used only when necessary.

DNA damage and cellular death in oral mucosa cells of children who have undergone panoramic dental radiography

BACKGROUND

Despite wide use as a diagnostic tool in medical and dental practice, radiography can induce cytotoxic effects and genetic damage.

OBJECTIVE

To evaluate DNA damage (micronucleus) and cellular death (pyknosis, karyolysis and karyorrhexis) in exfoliated buccal mucosa cells taken from healthy children following exposure to radiation during dental radiography.

MATERIALS AND METHODS

A total of 17 children who had undergone panoramic dental radiography were included.

RESULTS

We found no statistically significant differences (P > 0.05) between micronucleated oral mucosa cells in children before and after exposure to radiation. On the other hand, radiation did cause other nuclear alterations closely related to cytotoxicity including karyorrhexis, pyknosis and karyolysis.

CONCLUSION

Taken together, these results indicate that panoramic dental radiography might not induce chromosomal damage, but may be cytotoxic. Overall, the results reinforce the importance of evaluating the health side effects of radiography and contribute to the micronucleus database, which will improve our understanding and practice of this methodology in children.

Nuclear changes in tongue epithelial cells following panoramic radiography

This study aimed to investigate the effect of radiation from panoramic radiographs on the cells of the lateral border of the tongue by evaluating nuclear changes. Forty-two patients were included: 22 had one radiograph (Group I), and 20 required a repeat radiograph due to error in the first exposure (Group II). Material for the cytopathologic evaluation was collected before radiographs and 10 days later. Smears were stained with the Feulgen reaction and micronuclei, buds, broken eggs, karyorrhexis and binucleate cells were scored. The comparison of nuclear changes before and after radiation exposure in both groups revealed a statistically higher number of broken eggs, buds, karyorrhexis and binucleate cells 10 days after exposure (P=0.01). The number of karyorrhexis and binucleate cells was greater in group II (P=0.01). There was no change in the frequency of micronuclei before and after the radiographs. Radiation emitted during panoramic radiographs increased the number of nuclear anomalies (except micronuclei) in exfoliated cells of the lateral border of the tongue. This effect was more pronounced when the patients were exposed to a repeat radiograph, without however implying increased risk of irreversible tissue damage.

Using Arabidopsis thaliana as a model to study subzero acclimation in small grains

The suitability of using Arabidopsis as a model plant to investigate freezing tolerance was evaluated by observing similarities to winter cereals in tissue damage following controlled freezing and determining the extent to which Arabidopsis undergoes subzero-acclimation. Plants were grown and frozen under controlled conditions and percent survival was evaluated by observing re-growth after freezing. Paraffin embedded sections of plants were triple stained and observed under light microscopy. Histological observations of plants taken 1 week after freezing showed damage analogous to winter cereals in the vascular tissue of roots and leaf axels but no damage to meristematic regions. The LT(50) of non-acclimated Arabidopsis decreased from about -6 degrees C to a minimum of about -13 degrees C after 7 days of cold-acclimation at 3 degrees C. After exposing cold-acclimated plants to -3 degrees C for 3 days (subzero-acclimation) the LT(50) was lowered an additional 3 degrees C. Defining the underlying mechanisms of subzero-acclimation in Arabidopsis may provide an experimental platform to help understand winter hardiness in economically important crop species. However, distinctive histological differences in crown anatomy between Arabidopsis and winter cereals must be taken into account to avoid misleading conclusions on the nature of winter hardiness in winter cereals.

Genotoxicity of occupational exposure to wood dust: Micronucleus frequency and nuclear changes in exfoliated buccal mucosa cells

Occupational exposure to wood dust is associated with the occurrence of nasal cancer. In this study, we investigated micronuclei and nuclear changes (NCs: binucleates, karyorrhexis, karyolysis, and the "broken egg" effect) in exfoliated buccal cells of 20 workers exposed to wood dust and 20 age- and sex-matched controls. Micronucleus frequency and the frequency of each of the NCs were significantly higher for wood workers than controls (P < 0.01). Cigarette smoking was associated with increased frequencies of micronuclei and NCs in the buccal mucosa epithelium cells of both the control and exposed groups. Our findings indicate that buccal cells of wood workers display increased levels of genotoxicity and toxicity, and that these biomarker responses may be related to the increased cancer risk among wood workers.

Owens S, Livingston JD, Premkumar R. Freezing in nonacclimated oat: thermal response and histological observations of crowns during recovery

The complex nature of freezing in plants may be easier to understand if freezing is studied in nonacclimated plants at temperatures just below freezing. Thermal patterns of model systems frozen at –2.6 °C were compared with those of crown tissue from oat ( Avena sativa L.). Thermal patterns of live crowns more closely resembled those of fructan and sugar solutions with filter paper than of plain water or a BSA solution. When the percentage of water freezing in nonacclimated plants at –2.6 °C was manually limited to 10%, the survival was reduced from 100% in supercooled plants to 25%. During cold acclimation, the percentage of water freezing at –2.6 °C went from 79% to 54% after 3 weeks of cold acclimation and resulted in 100% survival. The nucleus of cells in the primary apical meristem of nonacclimated plants appeared to have disintegrated, an effect that was not observed in any cold-acclimated (unfrozen controls) plants. Nuclear pycnosis was observed in leaf sheaths surrounding the meristem and in cells directly below the meristem. Cells of secondary meristems and in the crown core appeared undamaged, but vessels in plants frozen for as little as 30 min were ruptured and appeared plugged. The distinctive nature of injury in the apical meristem and the rapid ability of the plant to acclimate during cold to the stress causing this injury indicate that specific tissue, namely the apical region of the crown, should be the focus of attention when attempting to determine cause and effect between genetics or metabolism and cold acclimation in winter cereals.