School of Dental Medicine, Complutense University of Madrid, Madrid, Spain.
Department of Dental Clinical Specialties, School of Dental Medicine, Complutense University of Madrid, Madrid, Spain.
Crit Rev Toxicol. 2021 Aug;51(7):622-633. doi: 10.1080/10408444.2021.1960271. Epub 2021 Nov 5.
Intraoral fixed appliances remain in the potentially corrosive environment of the mouth for an average of two years. Over time, corrosion causes the release of metal ions, such as nickel and chromium. These metals can become allergenic and cytotoxic, causing different conditions in the human body. The aim of this study therefore is to carry out a systematic review of the available scientific evidence on the accumulation of metal ions, and the genotoxic and cytotoxic effects in oral mucosa cells deriving from short- and long-term exposure to them. The systematic review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The primary outcome (quantification of metal ion deposits and assessment of their genotoxic and/or cytotoxic effects) and secondary outcome (complementary analysis of cytotoxic and genotoxic effects) were examined. The Cochrane Collaboration tool and Toxicological data Reliability Assessment Tool (ToxRTool) were used for quality assessment. Once the search was performed, a total of seven articles met the inclusion criteria and were included in this study. Two main techniques were used to assess genotoxic effects: alkaline comet assay (6/7) and micronucleus method (1/7). Cytotoxicity was evaluated (4/7) using the trypan blue dye test. Accumulations of nickel (7/7), chromium (5/7), and other metals (zinc, cobalt, iron, manganese, molybdenum, titanium) were also quantified. The results allowed us to conclude that release of metal ions and acute cell and DNA damage in oral mucosa cells takes place in the early stages of treatment. However, more long-term studies are needed to evaluate chronic exposure to metals and DNA damage, as well as cellular capacity to recover DNA integrity.
口腔内固定矫治器在口腔内的潜在腐蚀性环境中平均使用两年。随着时间的推移，腐蚀会导致金属离子（如镍和铬）的释放。这些金属可能会引起过敏和细胞毒性，从而导致人体出现不同的状况。因此，本研究旨在对现有关于金属离子积累以及短时间和长时间暴露于这些离子对口腔黏膜细胞的遗传毒性和细胞毒性影响的科学证据进行系统评价。该系统评价是根据系统评价和荟萃分析的首选报告项目（PRISMA）声明报告的。主要结局（金属离子沉积物的定量及其遗传毒性和/或细胞毒性影响的评估）和次要结局（细胞毒性和遗传毒性影响的补充分析）进行了检查。使用 Cochrane 协作工具和毒理学数据可靠性评估工具（ToxRTool）进行质量评估。在进行搜索后，共有 7 篇文章符合纳入标准并纳入本研究。有两种主要技术用于评估遗传毒性效应：碱性彗星试验（7/7）和微核法（1/7）。使用台盼蓝染料试验评估细胞毒性（4/7）。还对镍（7/7）、铬（5/7）和其他金属（锌、钴、铁、锰、钼、钛）的积累进行了定量。结果表明，金属离子的释放以及口腔黏膜细胞的急性细胞和 DNA 损伤发生在治疗的早期阶段。然而，需要进行更多的长期研究，以评估金属的慢性暴露和 DNA 损伤以及细胞恢复 DNA 完整性的能力。
