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BMC Oral Health
Published in: BMC Oral Health 1/2023

Open Access 01-12-2023 | Computed Tomography | Research

Does cone-beam computed tomography examination increase the micronuclei frequency in the oral mucosa exfoliated cells? A systematic review and meta-analysis

Authors: Pan Yang, Bin Xuan, Gang Li, Senrong Qi

Published in: BMC Oral Health | Issue 1/2023

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Abstract

Objective

This systematic review (SR) with meta-analysis aimed to evaluate the frequency of micronuclei in the oral mucosa exfoliated cells after cone-beam computed tomography (CBCT) examination.

Methods

We performed language-independent computer-assisted data searches using PubMed databases, Cochrane, Embase, Web of Science all databases, and Google Scholar. The literature on micronucleus (MN) frequency of clinical trials before and after CBCT examination was included. The frequency of MN in exfoliated cells of the human oral mucosa was the primary outcome of the study. All statistical analyses were performed with R (version 4.1.0), RStudio (version 2022.02.2 + 485) software, and Meta packages (version 5.2–0). Two reviewers independently assessed the quality of the included studies by the EPHPP (Effective Public Health Practice Project) Modified scale with minor modifications. The heterogeneity of the data was analyzed using I2 statistics, in which I2 > 50% was considered substantial heterogeneity.

Results

A total of 559 articles were selected through the search strategy. After screening titles and abstracts, nine full-text manuscripts were assessed for eligibility, and six observational studies were included in the meta-analysis. The present study showed a significant increase in MN frequency of human oral mucosal exfoliated cells 10 days after CBCT examination compared to baseline (SMD = − 0.56, 95%-CI = − 0.99 ~ − 0.13, p = 0.01). Because of the high heterogeneity among the studies (I2 = 72%), after removing one study that was the main source of heterogeneity, excluding the study (I2 = 47%), the common-effect model was chosen, and the meta-analysis also showed that the frequency of MN in human oral mucosa exfoliated cells increased significantly 10 days after CBCT examination (SMD =  − 0.35, 95%-CI =  − 0.59 ~  − 0.11, p = 0.004).

Conclusion

This review suggested that CBCT examination increases the frequency of micronuclei in oral mucosal exfoliated cells.
Appendix
Available only for authorised users
Literature
1.
Mozzo P, Procacci C, Tacconi A, Martini PT, Andreis IA. A new volumetric CT machine for dental imaging based on the cone-beam technique: preliminary results. Eur Radiol. 1998;8(9):1558–64.CrossRefPubMed
2.
Arai Y, Tammisalo E, Iwai K, Hashimoto K, Shinoda K. Development of a compact computed tomographic apparatus for dental use. Dentomaxillofac Radiol. 1999;28(4):245–8.CrossRefPubMed
3.
Venkatesh E, Elluru SV. Cone beam computed tomography: basics and applications in dentistry. J Istanbul Univ Faculty Dentistry. 2017;51(3 Suppl 1):S102-s121.
4.
Mettler FA Jr, Thomadsen BR, Bhargavan M, Gilley DB, Gray JE, Lipoti JA, McCrohan J, Yoshizumi TT, Mahesh M. Medical radiation exposure in the US in 2006: preliminary results. Health phys. 2008;95(5):502–7.CrossRefPubMed
5.
Roberts JA, Drage NA, Davies J, Thomas DW. Effective dose from cone beam CT examinations in dentistry. Br J Radiol. 2009;82(973):35–40.CrossRefPubMed
6.
Ludlow JB, Davies-Ludlow LE, Brooks SL. Dosimetry of two extraoral direct digital imaging devices: NewTom cone beam CT and Orthophos Plus DS panoramic unit. Dentomaxillofac Radiol. 2003;32(4):229–34.CrossRefPubMed
7.
Ludlow JB, Davies-Ludlow LE, Brooks SL, Howerton WB. Dosimetry of 3 CBCT devices for oral and maxillofacial radiology: CB Mercuray, NewTom 3G and i-CAT. Dentomaxillofac Radiol. 2006;35(4):219–26.CrossRefPubMed
8.
Li G. Patient radiation dose and protection from cone-beam computed tomography. Imag Sci Dentistry. 2013;43(2):63–9.CrossRef
9.
Ludlow JB, Ivanovic M. Comparative dosimetry of dental CBCT devices and 64-slice CT for oral and maxillofacial radiology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106(1):106–14.CrossRefPubMed
10.
Memon A, Rogers I, Paudyal P, Sundin J. Dental X-rays and the risk of thyroid cancer and meningioma: a systematic review and meta-analysis of current epidemiological evidence. Thyroid Off J Am Thyroid Assoc. 2019;29(11):1572–93.CrossRef
11.
Hwang SY, Choi ES, Kim YS, Gim BE, Ha M, Kim HY. Health effects from exposure to dental diagnostic X-ray. Environ Health Toxicol. 2018;33(4): e2018017.CrossRefPubMedPubMedCentral
12.
Jaju PP, Jaju SP. Cone-beam computed tomography: time to move from ALARA to ALADA. Imag Sci Dentistry. 2015;45(4):263–5.CrossRef
13.
Oenning AC, Jacobs R, Pauwels R, Stratis A, Hedesiu M, Salmon B. Cone-beam CT in paediatric dentistry: DIMITRA project position statement. Pediatr Radiol. 2018;48(3):308–16.CrossRefPubMed
14.
Lorenzoni DC, Fracalossi AC, Carlin V, Ribeiro DA, Sant’anna EF. Mutagenicity and cytotoxicity in patients submitted to ionizing radiation. Angle Orthod. 2013;83(1):104–9.CrossRefPubMed
15.
Carlin V, Artioli AJ, Matsumoto MA, Filho HN, Borgo E, Oshima CT, Ribeiro DA. Biomonitoring of DNA damage and cytotoxicity in individuals exposed to cone beam computed tomography. Dentomaxillofac Radiol. 2010;39(5):295–9.CrossRefPubMedPubMedCentral
16.
Yang P, Hao S, Gong X, Li G. Cytogenetic biomonitoring in individuals exposed to cone beam CTcomparison among exfoliated buccal mucosa cellscells of tongue and epithelial gingival cells. Dentomaxillofac Radiol 2017;20160413.
17.
da Fonte JB, Andrade TM, Albuquerque RL Jr, de Melo MFB, Takeshita WM. Evidence of genotoxicity and cytotoxicity of X-rays in the oral mucosa epithelium of adults subjected to cone beam CT. Dentomaxillofac Radiol. 2018;47(2):20170160.CrossRefPubMed
18.
Altoukhi DH, Alaki S, El Ashiry E, Nassif O, Sabbahi D. Genotoxicity and cytotoxicity of cone beam computed tomography in children. BMC Oral Health. 2021;21(1):427.CrossRefPubMedPubMedCentral
19.
Basha S, Essawy M. Genotoxic and cytotoxic effects of cone beam computed tomography on exfoliated buccal epithelial cells. IOSR J Dental Med Sci. 2018;17(3):66–70.
20.
Mosavat F, Mahdavi N, Safari S. Cytotoxicity, genotoxicity, and immunohistochemical expression of p53 in the oral mucosal epithelium of adults following cone-beam computed tomography. Mutation Res Genetic Toxicol Environ Mutagenesis. 2022;879–880: 503496.CrossRef
21.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ (Clin Res ed). 2021;372: n71.
22.
Thomas BH, Ciliska D, Dobbins M, Micucci S. A process for systematically reviewing the literature: providing the research evidence for public health nursing interventions. Worldviews Evi-based Nurs. 2004;1(3):176–84.CrossRef
23.
Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ (Clin Res ed). 2003;327(7414):557–60.CrossRef
24.
Mounika G, Sridevi K, Krishnaveni B, Kumar NP, Naidu H, Sahi BK. Evaluation of genomic damage from buccal epithelial cells in patients subjected to cone beam computed tomography. J Indian Academy Oral Med Radiol. 2022;33(4):372–8.CrossRef
25.
Holland N, Bolognesi C, Kirsch-Volders M, Bonassi S, Zeiger E, Knasmueller S, Fenech M. The micronucleus assay in human buccal cells as a tool for biomonitoring DNA damage: the HUMN project perspective on current status and knowledge gaps. Mutat Res. 2008;659(1–2):93–108.CrossRefPubMed
26.
Santos M, Couto GR, Sabey MJS, Borges DPR, Takeshita WM. Can exposure to panoramic radiographs induce genotoxic effects on the oral epithelium? A systematic review with meta-analysis. Dentomaxillofac Radiol. 2022;51(2):20210149.CrossRefPubMed
27.
Arora P, Devi P, Wazir SS. Evaluation of genotoxicity in patients subjected to panoramic radiography by micronucleus assay on epithelial cells of the oral mucosa. J Dentistry. 2014;11(1):47–55.
28.
Dias VM, Manelli-Oliveira R, Machado-Santelli GM. Using fluorescence for improvement of the quantitative analysis of micronucleus in cell culture. Mutat Res. 2005;565(2):173–9.CrossRefPubMed
29.
Thomas P, Fenech M. Buccal micronucleus cytome assay. Methods Mole Biol. 2011;682:235–48.CrossRef
30.
Popova L, Kishkilova D, Hadjidekova VB, Hristova RP, Atanasova P, Hadjidekova VV, Ziya D, Hadjidekov VG. Micronucleus test in buccal epithelium cells from patients subjected to panoramic radiography. Dentomaxillofac Radiol. 2007;36(3):168–71.CrossRefPubMed
31.
Tolbert PE, Shy CM, Allen JW. Micronuclei and other nuclear anomalies in buccal smears: methods development. Mutat Res. 1992;271(1):69–77.CrossRefPubMed
32.
Ludlow JB, Timothy R, Walker C, Hunter R, Benavides E, Samuelson DB, Scheske MJ. Effective dose of dental CBCT-a meta analysis of published data and additional data for nine CBCT units. Dentomaxillofac Radiol. 2015;44(1):20140197.CrossRefPubMed
33.
Sterne JA, Sutton AJ, Ioannidis JP, Terrin N, Jones DR, Lau J, Carpenter J, Rücker G, Harbord RM, Schmid CH, et al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ (Clin Res ed). 2011;343: d4002.CrossRef
Metadata
Title
Does cone-beam computed tomography examination increase the micronuclei frequency in the oral mucosa exfoliated cells? A systematic review and meta-analysis
Authors
Pan Yang
Bin Xuan
Gang Li
Senrong Qi
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-023-02832-3

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