Exploratory Buccal Cytological Changes After Panoramic Radiography

Introduction and aims Panoramic radiography is widely used in dental diagnosis, but short-term buccal-cell changes and possible age-related differences remain uncertain. This exploratory, age-stratified repeated-measures observational study evaluated micronucleus-related and cytotoxicity outcomes before and 10 to 12 days after clinically indicated panoramic radiography in participants aged 15 to 25 years and 40 to 50 years. Methods Thirty participants were classified into two age groups: 15 to 25 years and 40 to 50 years, with 15 participants in each group. Micronucleated cells, total micronuclei, pyknosis, karyorrhexis, and karyolysis were scored per 2000 cells at each time point. Repeated count outcomes were analysed using generalized linear mixed-effects models with participant-specific random intercepts. The principal inferential test was the age-group-by-time interaction. Results The age-group-by-time interaction was not statistically significant for micronucleated-cell count (ratio of rate ratios [RRR] = 1.65, 95% confidence interval [CI] 0.83-3.27; P = .146) or total micronucleus count (RRR = 1.62, 95% CI 0.82-3.21; Holm-adjusted P = .636). The corresponding interactions for pyknosis, karyorrhexis, and karyolysis were also not statistically significant after Holm adjustment. Both the nonparametric change-score analyses and the sex- and dose-area product-adjusted sensitivity model yielded the same overall inference. Conclusion Neither the principal age-group-by-time interaction nor any Holm-adjusted secondary interaction was statistically significant. These exploratory findings do not provide evidence of an age-dependent short-term cytological response; in the absence of a concurrent unexposed group, the observed pre-to-post changes cannot be attributed causally to panoramic radiography. Clinical relevance The findings do not support age-specific changes in panoramic imaging practice. Panoramic examinations should continue to be clinically justified and exposure parameters optimized for the diagnostic task, with unnecessary repeat imaging avoided.