Genotoxicity and Cytotoxicity of Cone Beam Computed Tomography Compared to Panoramic and Bitewing Radiographs in Children

Dental radiographs play a crucial role in diagnosis. However, radiation has a cumulative effect on children and may lead to carcinogenesis.

To determine the genotoxicity and cytotoxicity in buccal mucosal cells of children exposed to panoramic and bitewing radiographs or Cone Beam Computed Tomography (CBCT) at various time intervals.

A cohort study was conducted involving 38 healthy children (ages 6-12), divided into two groups: one group received panoramic and bitewing radiographs, and the other underwent CBCT. Buccal mucosal cells were collected at baseline, and follow-ups occurred at 10±2 days, one month, and three months post-exposure. Cells were stained using Feulgen/fast green and analyzed microscopically for genotoxic (micronuclei) and cytotoxic (condensed chromatin, karyolysis, pyknosis, karyorrhexis) markers.

At the 10±2 days mark, an increase in micronuclei was observed in both groups, with no significant difference (p=0.660). However, after one month, the percentage of micronuclei was significantly lower in the CBCT group compared to the first group (p < 0.001). Cytotoxic alterations showed a comparable pattern, with transient increases in both groups that returned to baseline at three months.

The findings indicate transient and reversible genotoxic and cytotoxic effects in buccal mucosal cells due to radiographic exposure. While CBCT exhibited lower micronuclei counts after one month, both modalities showed similar patterns of cellular damage.

These results highlight the importance of adhering to the ALARA principle in pediatric dentistry, as the observed effects of dental radiography are transient and do not indicate long-term damage. Further research is recommended to explore these effects in larger populations.