The Effects of Three Chlorhexidine-Based Mouthwashes on Human Osteoblast-Like SaOS-2 Cells. An In Vitro Study.

Giulia Brunello,Jürgen Becker,Luisa Scotti,Kathrin Becker,Gordon John,Dieter Drescher

doi:10.3390/ijms22189986

Abstract

Several decontamination methods for removing biofilm from implant surfaces during surgical peri-implantitis treatment have been reported, including the intraoperative usage of chlorhexidine (CHX)-based antiseptics. There is a lack of information on possible adverse effects on bone healing. The study aimed to examine the impact of three CHX-based mouthwashes on osteoblast-like cells (SaOS-2) in vitro. Cells were cultured for three days in 96-well binding plates. Each well was randomly treated for either 30, 60 or 120 s with 0.05% CHX combined with 0.05% cetylpyridinium chloride (CPC), 0.1% CHX, 0.2% CHX or sterile saline (NaCl) as control. Cell viability, cytotoxicity and apoptosis were assessed at day 0, 3 and 6. Cell viability resulted in being higher in the control group at all time points. At day 0, the CHX 0.2 group showed significantly higher cytotoxicity values compared to CHX 0.1 (30 s), CHX + CPC (30 s, 60 s and 120 s) and control (60 s and 120 s), while no significant differences were identified between CHX + CPC and both CHX 0.1 and NaCl groups. All test mouthwashes were found to induce apoptosis to a lower extent compared to control. Results indicate that 0.2% CHX presented the highest cytotoxic effect. Therefore, its intraoperative use should be carefully considered.

Highlights

The non-surgical approach represents a fundamental step in the initial treatment of peri-implantitis, in cases of recurrence of bleeding and suppuration, it has to be followed by surgical therapy, which allows a better access for an effective removal of the biofilm from the contaminated implant surfaces [5]
Variable mouthwashes containing chlorhexidine (CHX) at different concentrations, alone or in combination with cetylpyridinium chloride (CPC), on osteoblast-like cells (SaOS-2) cultured for 2 h, 3 days and 6 days after different exposure times to the mouthwashes tested in this study (i.e., 30 s, 60 s and 120 s)
Except for day 0, in which CHX 0.2 showed higher values than CHX 0.1 at 30 s application time as well as higher values than CHX + CPC at an application time of 120 s, cell viability was comparable among the tested mouthwashes

Summary

Introduction

The non-surgical approach represents a fundamental step in the initial treatment of peri-implantitis, in cases of recurrence of bleeding and suppuration, it has to be followed by surgical therapy, which allows a better access for an effective removal of the biofilm from the contaminated implant surfaces [5]. To this aim, several mechanical and chemical techniques have been proposed; no particular decontamination protocol has been demonstrated to be superior [5,6,7]

Objectives

Methods

Discussion

Conclusion