Oral Health and Dental Management

Abstract

The Effect of Titanium Implant on Oral Mucosal Epithelium

Warkaa M Ali AL-Wattar

Titanium dental implant is widely spread as replacement of missing teeth now a day. Their increased use may develop a new problem that may have risk on the patients including oral cancer. This study represents the first study in Iraq that deal with the subject of genotoxic effect of titanium dental implant from cytological point of view. Aims: the aim of this study was assess the effect of titanium dental implant on oral mucosa by using cytomorphometry. Material and methods: 15 female Iraqi patients were included in this study at the implant clinic of college of dentistry –Al-Mustansiriyah university. We compared the presence of micronucleus, cluster sheets, CD, ND and the ratio of nuclear diameter to cellular diameter (N\C) of gingival mucosa of implant site(A) with adjacent normal tooth(B). The two groups were examined in two stages; one at abutment exposure visit and the second in recall visit for impression. Giemsa stain was used to stain slides for cytological investigation of exfoliated squamous epithelial cells. Results: The results for epithelial cluster shedding and micronucleus was 7(46.7%), 3(20%) for group A1 and 7(46.7%), 2(13%) for group B1. While was 12(80%) 9(60%) for group A2, 12(80%), 7(46.7%) for group B2 respectively. There was significant correlation (P<0.05) between micronucleus in group A1 and cluster shedding in groupB1 while highly significant correlation (P<0.001) with micronucleus in group B1. The mean CD and ND values were: Group A1: 3807.57 (± 710.4) and 1251.4281 (± 621.213); Group B1: 4202.9932 (± 912.8) and 1261.8046 (± 1176.1); Group A2: 4272.343 (± 650.457) and 1323.9878 (± 496.55); Group B2: 3852.2070 (± 943.8) and 1290.373 (± 559.77) urn, respectively. Correlation between the ND and CD among the groups in the two stages were highly significant (P<0.001) for nucleus diameter in group A1 with that of A2 and B2; and nucleus diameter in group A2 with that of B2, while the nucleus diameter in group B1 reversed significant (P<0.05) with cellular diameter in group B2. The ratio of N\C diameter was nearly not changed between the groups. Univariate analysis of variance (ANOVA) showed a significant group effect for cellular diameter, nuclear diameter and. Multiple comparison test by Tukey-HSD procedure revealed a significant decrease in the mean cellular diameter, increase in the nuclear diameter. The results indicate that titanium dental implant could have dysplastic effects that could be changed to oral malignancy especially squamous cell carcinoma. Conclusion: Cytomorphometric changes could be the earliest indicators of cellular alterations. There is progressive decrease in cellular diameter, increase in nuclear diameter in addition to increase in the formation of micronucleus and cluster sheet of epithelium in smears from all implant sites, as compared to normal adjacent teeth. This indicates that titanium implant could have a genotoxic effect on oral epithelium that causes cellular alteration.