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Micronucleus formation in oral mucosal cells following dental X-ray exposure: a systematic review and meta-analysis
Yaxin Wang1, Rozita Hassan1, Liyana Ghazali2
1Unit of Orthodontics, School of Dental Science, USM Health Campus, Kota Bharu, Kelantan 15200, Malaysia.
Background:
Radiographic imaging is essential in dental diagnostics, yet concerns persist regarding its genotoxic impact. While digital advancements have reduced radiation doses, the effects of X-ray exposure on oral mucosal cells remain debated. This study systematically reviews and quantitatively analyses the effects of X-ray exposure on micronucleus (MN) formation in oral epithelial cells, examining potential age-related variations.
Methods:
A thorough literature review was performed across PubMed, Web of Science, EBSCO, and Scopus (updated to November 2024), adhering to PRISMA criteria. Eligible studies examined cytogenetic changes in oral epithelial cells after X-ray exposure in healthy individuals. Data extraction covered study design, imaging modality, radiation dose, MN frequency, and statistical methods. Risk of bias was assessed using a modified Effective Public Health Practice Project tool. A random-effects model synthesized MN frequency changes, and Fisher's Z-transformation analysed age correlations.
Results:
Eighteen studies met the inclusion criteria, with 16 centred on panoramic imaging and 2 examining a combination of cone-beam computed tomography and lateral cephalometric X-rays. Meta-analysis confirmed a significant increase in MN frequency post-exposure (standardized mean difference = 0.30, 95% CI: 0.07-0.52, P = .01), indicating genotoxic effects. However, age showed a weak correlation with MN formation (r = 0.149, 95% CI: -0.009 to 0.3, P = .065).
Conclusions:
X-ray exposure induces measurable genotoxic damage in oral epithelial cells, though age-related effects remain inconclusive. Adhering to the ALARA principle is crucial to minimizing unnecessary radiation. Future studies should employ larger cohorts and refined biomarkers to enhance risk assessment.
