SynthesisJournal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology2025
Biological Consequences and Assessment Methods Analysis of Fixed Orthodontic Appliances on Oral Epithelial Cells: A Systematic Review.
Synthesis in Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Biological Consequences and Assessment Methods Analysis of Fixed Orthodontic Appliances on Oral Epithelial Cells: A Systematic Review.Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology · 2025Pooled it
- Micronuclei and cytomorphometric alterations in fixed (metal/ceramic) and removable orthodontic appliances: a prospective exploratory comparative study.Clinical oral investigations · 2026Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionFixed orthodontic appliances (OAs) expose the oral mucosa to mechanical traumas and metal ions throughout the whole orthodontic therapy. This review aims to understand the cytological and genetic changes consequent to fixed orthodontic therapy, their clinical implications, and how they can be assessed. MATERIALS AND
methodsA comprehensive search was conducted in PubMed (MEDLINE), Scopus, and Web of Science using MeSH terms related to cytology, DNA damage, mutagenicity, and orthodontic appliances. The PICO model and PRISMA guidelines were followed. The risk of bias was assessed using the ROBINS-I tool, and study quality was evaluated with the NHLBI Quality Assessment Tools. Two independent evaluators assessed the methodological quality of the included studies using the Joanna Briggs Institute (JBI) levels of evidence; inter-reviewer agreement was measured using Cohen's kappa coefficient (κ = 0.80).
resultsNineteen prospective and cross-sectional studies were included in the analysis. The findings suggest the presence of higher metal cellular content, as well as cytological changes, nuclear alterations, and cytotoxic and genotoxic effects. Different appliance compositions and treatment durations may influence the biological consequences. The analysis shows a tendency toward regression, especially for nuclear alterations. No dysplastic changes have been observed in any of the studies included.
conclusionOAs cause cellular alterations, which tend to be reversible and do not seem to evolve into dysplastic changes. Future research should focus on longitudinal studies with standardized methodologies to better understand the persistence and reversibility of the changes associated with OAs, as well as exploring alternative materials that pose less risk during orthodontic treatment.
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