Almashharawi, Rami K.M.
(2018)
Comparison of cell viability, cytomorphometric and periodontal index of human oral mucosal cell exposed to two conventional fixed orthodontic appliances.
Masters thesis, Universiti Sains Malaysia.
Abstract
The corrosive environment of the oral cavity is a major cause of concern during
the use of orthodontic appliances. The reasons are because fixed orthodontic appliances
are made from different alloys materials. Exposure of soft tissues to these materials while
using the appliances may lead to some chemical reactions due to material degradation
which may release certain type of ions. The study aims to analyse the cell viability
changes, and cytomorphometric alterations in the nuclear area (NA), cytoplasmic area
(CA), and nuclear-cytoplasmic ratio (N/C) of the human buccal mucosa of patients treated
with metallic and ceramic orthodontic appliances respectively. The study was also carried
out to assess the periodontal health of patients under those orthodontic treatments. In this
study, twenty-six subjects who were orthodontic patients attending Dental Clinic at
Hospital Universiti Sains Malaysia were recruited. The subjects were divided into two
groups; one group was treated with metallic appliances (n=13), while another was treated
with ceramic appliances (n=13). The buccal swab was taken from each participant three
times, prior to treatment (baseline), at 3-month post-treatment, and then at 6-month posttreatment.
To examine the periodontal health of patients, four periodontal parameters were
assessed at the same time points; plaque index (PI), bleeding on probing (BOP),
periodontal pocket depth (PPD) and clinical attachment loss (CAL). Cell viability of the
oral buccal mucosa was evaluated using Trypan blue staining, followed by lightmicroscopy analysis. For cytomorphometry, the cells were stained using Papanicolaou
stain, followed by an assessment using ImageJ software. All data were subjected to
statistical analysis. At 3-month both metallic (56.01±SE1.69, p ≤ 0.05) and ceramic
(64.41±SE 1.34, p ≤ 0.05) groups showed a significant decrease in the cellular viability
respectively in comparison to the baseline group. Cytomorphometry analysis of the buccal
mucosa cells at 3-month showed a significant decrease of NA in both metallic (45.5±SE
0.94, p ≤ 0.05) and ceramic (55.2±SE 0.63, p ≤ 0.05) groups. The N/C ratio was (30.1±SE
1.02, p ≤ 0.05) for metallic, while ceramic was (41.1±SE 0.92, p ≤ 0.05). The analysis
showed that there was an increase in CA of metallic (125.1±SE 1.22, p ≤ 0.05) in
comparison to ceramic (118.3±SE 1.16, p ≤ 0.05). PI analysis showed a significant
increased at 3-month in both metallic (1.98±SD0.39, p ≤ 0.05) and ceramic groups
(1.7±SD0.45, p ≤ 0.05). Similarly, BOP showed a significant increased at 3-month in both
metallic (0.30±SD0.09, p ≤ 0.05) and ceramic groups (0.20±SD0.08, p ≤ 0.05). PPD
showed no significant difference at 3-month in both metallic (1.88±SD0.61, p ≥ 0.05) and
ceramic group (1.86±SD0.60, p ≥ 0.05), similar to CAL, in which the metallic group is
(1.99 ±SD0.72, p ≥ 0.05) and the ceramic group is (1.98±SD0.87, p ≥ 0.05). However, all
investigated variables and parameters have no significant difference at 6-month in
comparison to the baseline group. Fixed metallic and ceramic orthodontic appliances can
induce cytotoxicity to the buccal mucosa cells, changes in cellular morphology and affects
periodontal health at 3-month after the orthodontic treatment. These changes were more
prominent in the metallic group, while all changes at 6-month showed no significant
difference which indicates cells tolerance for healing. Both metallic and ceramic
appliances are considered biocompatible. Using ceramic appliances being more
advantageous.
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