An integral part of modern telecommunication is the mobile phone, which may have negative effects on different organs and cells. These negative impacts culminate from radiofrequency electromagnetic radiation (RFER) emitted from mobile phones.Mobile phones are the important aspect of modern telecommunications but may have adverse impact on human health. Mobile phones emit
radiofrequency electro -magnetic radiations (RFER). Biocompatibility of dental alloy has been investigated over the past 20 years. 1 NiTi alloys were introduced for use as orthodontic wires in the 1970s.2 Because titanium is mainly inert and non-cytotoxic; the main potential risk of cytotoxicity is due to biologic side effect of nickel.
Nickel alloys are well known to be allergenic, cytotoxic and mutagenic. Nickel containing alloys are present in a substantial number and wide variety of appliances, auxiliaries and utilities used in orthodontics and thus become an integral part of almost every routine orthodontic intervention. The anatomic location of parotid gland makes it conceivable candidate to be influenced by exposure to RFER on the side of head where mobile phone is held.3 Thus, the RFER emitted from the mobile phones may influence the amount of nickel released from the fixed orthodontic appliance.
A before and after non randomized trial with control group assessed antagonist effects of mobile on fixed orthodontic treatment. Sample size estimation was done using G power software and was done based on the results of pilot study on 15 subjects. The estimation revealed a sample of 54 subjects and the present study is based on the assessment of results of these 54 subjects. Ethical clearance was obtained from Institutional Review Board of Modern Dental College & Research Centre, Indore. Participants were informed prior about the study and a written informed consent was taken prior to the start of study.
The eligibility criteria in the present study comprised of inclusion and exclusion criteria and included. Candidate agreed to participate in the study. Candidate needed placement of fixed orthodontic appliance.
The Exclusion criteria included patient with systemic disease or medication intake. Smokers or Alcohol consumers. Those with any metallic restorations. 54 subjects not undergoing any orthodontic treatment were selected for the study. The subjects were divided into control and experimental group. Subjects were first asked not to use their cell phones for a week and provide their saliva samples. Same patients were instructed to use their phones for 45 min a day for the following week and stopwatch was given to them Recall was done after 1 week of previous assessment at same time with use of cell phones and salivary samples were again recorded (Control Group). The experimental group comprised of the same group of patients who were than undergoing orthodontic treatment and assessment was done both without using and after using mobile phones with.
Both the samples were collected in a sterile Ni free container and stored at -20 degree Celsius temperature.
After banding, bonding and initial arch wire placement patient were recalled after 15 days and instructed not to use their phones. Again the samples were collected. Now patients were told to use their phones for 45 minutes till one week and again come for sample collection at the same time. Stop watch are again given to them to monitor the time. The samples were run under Atomic absorption spectrophotometer (AAS) ISO 9001:2015 to measure the amount of Ni in saliva samples. The armamentarium used in the present study comprised of 20 ml Ni free sterile container, Distilled water, Stop watch, Ice gel packs, Atomic absorption spectrophotometer (AAS). The compliance of patients was assured as they were allowed a maximum of 45 minutes to use their mobile phones in case of any emergency.
The data collected was entered in Microsoft Excel and subjected to statistical analysis using Statistical Package for Social Sciences (SPSS, IBM version 20.0). The level of significance was fixed at 5% and p ? 0.05 was considered statistically significant. Evaluation of mean values of nickel release in control and experimental group was done by paired and unpaired t test.
The results of paired t test revealed no significant difference in control group where no NiTi wire was placed whereas a highly significant difference was seen in nickel level in the experimental group. Similar to the results of experimental group a highly significant difference was also seen between the level of nickel in patients when independent samples of mobile usage and without mobile usage were compared with each other.
Mobile phones are known to generate heat and emit RFER in the form of non-ionizing electromagnetic radiations in the range of 800-2200 MHz.4,5The objective of the study was to examine whether the use of mobile phones influences the nickel released from fixed orthodontic appliances in saliva. The main outcome was higher level of Ni is found in saliva of patients using their mobile phones after comparison from those which are not using. According to a study conducted by Goldwein O, Aframian D 4 in 2010 the effect of using the mobile phones on the parotid gland were studied and it was concluded that Parotid glands adjacent to handheld mobile phones in use respond by elevated salivary rates which was very similar to our study. Heavy users of mobile phones demonstrated increased rate of salivary flow and greater volumes of the parotid gland which have a diluting effect, mostly on salivary macromolecules and to a lesser extent on ions since the ions diffuse relatively easily along with watery secretions. 6 Our results showed that concentrations of nickel ions after using a cell phone for 1 week significantly higher than the concentration in the pretreatment group. This might be attributed to the greater flow rate which in turn results in more nickel released from fixed orthodontic appliance into the saliva. Thus, the necessity of studying the effects of this radiations on metal ion released from fixed orthodontic appliance seems to be undeniable. 3
Though significant difference is present between the level of nickel in patient with and without NiTi wires when mobile phones were not used and highly significant difference when mobile phones are used.
But, according to the outcome of the study, it can be concluded that ions were released in doses after using mobile phones that are nontoxic to humans.
Limitations: This study depends on patient’s compliance and further large scale studies which should include more parameters like specification of individual mobile phone radiation and brands should be taken into consideration.