Effect of orthodontic fixed appliances on epithelial cells morphology of buccal mucosa after orthodontic treatment

Abstract

The aim of this study, was to evaluate the effect of orthodontic fixed appliances on epithelial cells morphology of buccul mucosa after orthodontic treatment using exfoliative cytology. Materials and Methods. Oral epithelial cells of buccal mucosa were obtained by exfoliative cytology from 32 orthodontic patients in three times: Day 0 (just after appliance removal), 30 and 60 days after appliance removal. The following regions were evaluated: a) oral mucosa adjacent to lower incisors brackets, b) oral mucosa adjacent to upper canine brackets in right side; and c) oral mucosa adjacent to upper first molar bands in right side. Nuclear (NA) and cytoplasmic (CA) areas and NA/CA ratio were assessed by an image analysis system. Cell morphology and cellularity were also analyzed by Papanicolau technique. SPSS 20 was used for statistical analysis. Mean and standard deviation were assessed for the values of descriptive statistical analysis. Friedman test were done to analysis quantitative variables and if the differences were significant subsequent Wilcoxon test was done. For analyzing qualitative variables Chi- Square test was done. Result. The NA, CA and NA/CA values of the cells adjacent to orthodontic devices increased after removal of orthodontic appliances significantly from T0 to T60(p<0.001) except the NA/CA values in the lower incisors region which did not change significantly (p=0.250). In morphological analysis with Papanicolau technique only class I smears were observed in all time and all regions. Superficial epithelial cells, were predominant cell type in Upper molar and lower incisors regions in all times. However in the upper canine area the prevalence of superficial oral intermediate cells were similar. The highest number of intermediate cells were observed 60 days after removal of orthodontic appliances. Conclusion. Preclinical alteration in the epithelial cells of oral mucosa, caused by orthodontic appliances was increase in cell keratinization especially in the upper molar region. After removal of orthodontic appliances cell activity increased and a decrease in cell keratinization was observed.