Assessment Of Cytotoxicity Of Chlorhexidine Containing Mouthrinses By Micronucleus Test In Exfoliated Buccal Epithelial Cells
Cytotoxicity Of Chlorhexidine By Micronucleus Test
Keywords:
micro nucleus test, chlorhexidine, exfoliative cytology, cytotoxicity, Feulgen reactionAbstract
Background & Objective: Chlorhexidine mouth rinses are utilized worldwide on regular basis in oral
hygiene practice for plaque control. Studies have shown that chlorhexidine has toxic effects on a variety of eukaryotic
cells. Micronuclei count in exfoliative cells is an economical and non invasive diagnostic method for evaluation of
cytotoxic effects of many carcinogens/ co-carcinogens. The present study was conducted in order to evaluate
frequency of micronuclei in buccal epithelial cells of patients using chlorhexidine containing mouthrinses.
Methodology: Study included 50 subjects, of whom 30 having clinically suspected mild gingivitis, rinsed with
chlorhexidine; 20 control subjects, rinsed with saline. Buccal epithelial cells were collected with a brush before and
after one week of usage of chlorhexidine by patients and physiologic saline by controls. Cells subjected to Fuelgen
reaction and analysed by two independent observers for micronuclei counts. Results: Considerable increase in
micronuclei count was noted in patients using chlorhexidine compared to controls. Conclusion: Present study
suggests that chlorhexidine has cytotoxic effects and further studies involving the therapeutic use of different
mouthrinses for a longer duration may provide justification for their usage in clinical practice. [Vinod Kumar MP
NJIRM 2016; 7(3): 75 - 79]
References
controlling plaque and gingivitis. J Clin Periodontol.
1988; 15: 488–498.
2. Erdemir EO, Şengün A, Ülker M. Cytotoxicity of
mouth rinses on epithelial cells by micronucleus
test.. Eur J Dent. 2007; 1: 81-85.
3. Valverde M, del Carmen Lopez, I Lopez, I Sanchez
TI, Fortoul P, Ostrosky-Wegman E, Rojas. DNA
damage in leukocytes and buccal and nasal
epithelial cells of individual exposed to air
pollution in Mexico City. Environ Mol Mutagen.
1997; 30: 147-152.
4. Saran R, Tiwari RK, Reddy PP, Ahuja YR. Risk
assessment of oral cancer in patients with precancerous
states of the oral cavity using
micronucleus test and challenge assay. Oral Oncol.
2008; 44: 354-60
5. Majer BJ, Laky B, Knasmuller S, Kassie F. Use of
micronucleus assay with exfoliated epithelial cells
as a biomarker for monitoring individuals at
elevated risk of genetic damage and in
chemopreventive trials - Review. Mutation
Research. 2001; 489: 147-172.
6. Nersesyan A, Kundi M, Atefie K, Hermann RS,
Knasmuller S. Effect of staining procedures on the
results of micronucleus assays with exfoliated oral
mucosa cells. Cancer Epidemiol Biomarkers and
Prev. 2006;15: 1835-1840.
7. Maffei F, Angelini S, Forti GC, et al. Micronuclei
frequencies in hospital workers occupationally
exposed to low levels of ionizing radiation:
influence of smoking status and other factors.
Mutagenesis. 2002; 17(5): 405-409.
8. Holland N, Bolognesi C, Kirsch-Volders M, Bonassi
S, Zeiger E et al. The micronucleus assay in human
buccal cells as a tool for biomonitoring DNA
damage: The HUMN project perspective on
current status and knowledge gaps - Review.
Mutation Research. 2008; 659: 93-108.
9. Bloching M, Hofmann A, Lautenschlager Ch,
Berghaus A, Grummt T. Exfoliative cytology of
normal buccal mucosa to predict the relative risk
of cancer in the upper aerodigestive tract using the
MN-assay. Oral Oncol. 2000: 550-555.
10. Tolbert PE, Shy CM, Allen JW. Micronuclei and
other anomalies in buccal smears: methods
development. Mutation Research 1992;271:69-77
11. Carlin V, Matsumoto MA, Saraiva PP, Artioli A,
Oshima CT, Ribeiro DA. Cytogenetic damage
induced by mouthrinses formulations in vivo and
in vitro. Clin Oral Invest. DOI 10.1007/s00784-011-
0559-2.
12. Sarto F, Finotto S, Giacomelli L, Mazzotti D,
Tomanin R, Levis AG.. The micronucleus assay in
exfoliated cells of the human buccal mucosa.
Mutagenesis. 1987;2(1): 11-17.
13. Gandhia PK, Shah N, Nahata S, Patel S, Patel K,
Pithawala M et al. Cytogenetic analysis of
radiotherapeutic and diagnostic workers
occupationally exposed to radiations. Int J Hum
Genet. 2004;4(1): 65-69.
14. Ozkul Y, Donmez H, Erenmemisoglu A, Demirtas H,
Imamoglu N. Induction of micronuclei by
smokeless tobacco on buccal mucosa cells of
habitual users.. Mutagenesis. 1997;12(4):285-287.
15. Pastor S, Gutierrez S, Creus A, Xamena N, Piperakis
S, Marcos R. Cytogenetic analysis of Greek farmers
using the micronucleus assay in peripheral
lymphocytes and buccal cells. Mutagenesis. 2001;
16(6): 539-545.
16. Negrelo Newton AP, Cadena SM, Merlin Rocha ME,
Skäre Carnieri EG, Martinelli de Oliveira MB. New
data on biological effects of chlorhexidine: Fe2+
induced lipid peroxidation and mitochondrialpermeability transition. Toxicology Letters.
2004:407-416.
17. Lessa FC, Aranha AM, Nogueira I, Giro EM, Hebling
J, Costa CA. Toxicity of chlorhexidine on
odontoblast-like cells. J Appl Oral Sci. 2010; 18(1):
50-8.
18. Giannellia M, Chellini F, Margherib M, Tonellia
P,Tanib P. Effect of chlorhexidine digluconate on
different cell types: A molecular and ultrastructural
investigation. Toxicology in Vitro. 2008; 22:308–
317.
19. Angelieri F, de Cássia Gonçalves Moleirinho T,
Carlin V, Oshima CT, Ribeiro DA. Biomonitoring of
oral epithelial cells in smokers and non-smokers
submitted to panoramic X-ray: comparison
between buccal mucosa and lateral border of the
tongue. Clin Oral Invest. 2010; 14:669–674.
