Diagnóstico radiológico em medicina dentária e alterações citogenéticas na mucosa oral

: revisão da literatura

Abstract

Introduction: During the use of radiological diagnostic techniques in dentistry, the oral mucosa is directly exposed to ionizing radiation, a mutagenic agent. Objective: To investigate the existence of a possible relationship between the use of diagnostic radiological techniques in dentistry and the occurrence of cytogenetic changes in the oral mucosa. Material and methods: Systematic review conducted using the PRISMA methodology, based on PICO criteria. The search was performed in PubMed and Web of Science databases, using a search expression based on the following MeSH terms: (Mouth mucosa) AND ((Chromosome Aberrations) OR (Cytogenetic Analysis) OR (Cytogenetics) OR (DNA damage) OR (Mutagenicity Tests)) AND ((Dental radiography) OR ((Dentistry) AND (Diagnostic imaging))). Results: From the 246 records obtained by searching the search engines, 30 articles were selected. Most studies resulted from the use of Panoramic Radiography (PAN) (63.3%), were performed on exfoliated cells of the oral mucosa (50.0%), with pre-irradiation (control) and post-irradiation sampling, mostly 10 days after irradiation (56.7%). In the vast majority of studies (66.7%), cytological analysis was performed to determine the frequency of micronuclei (MN) and degenerative nuclear changes (pyknosis, karyolysis and karyorrhexis). In all studies, regardless of the radiographic imaging technique used, diagnostic irradiation was associated with significant increases (p < 0.05) in at least one of the cytotoxicity indicator parameters. Most studies considered also showed positive results for genotoxicity (46.7%). Upon stratification analysis, a higher frequency of positive genotoxicity results was observed for CBCT-based studies (23,3% vs 63,3% for panoramic radiography) and for comet assay-based results (10,0% vs 86,7% for MN frequency analysis). Conclusion: According to the studies included in this systematic review, the use of radiological diagnostic techniques in dentistry is associated with cytotoxic and, eventually, genotoxic alterations in the oral mucosa. Considering the frequency of use of these techniques, further studies are needed to confirm their possible genotoxicity and policy changes are needed to reinforce measures to minimize the deleterious effects of these vastly used techniques of indisputable clinical utility.

Date of Award	13 Jul 2022
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Luís Santos (Supervisor), Maria José Correia (Co-Supervisor) & Raquel Silva (Co-Supervisor)