Host tissue responses to chronic polymicrobial stress in oral mucosa and the modulatory role of chlorhexidine

Abstract

Objective: The purpose of the study was to explore inflammatory and structural reactions of the oral mucosa and supportive tissues to chronic polymicrobial stress, and the absorption of the effects of chlorhexidine as a modulator.

Methods: An ex vivo human oral mucosal test model. There were three groups of tissue samples: control, bacterial stress, and bacterial stress with chlorhexidine (0.12%). The assessments of histological and macroscopic tissue changes were performed using a semi-quantitative scoring system. One-way ANOVA was used to conduct the statistical analysis.

Results: There were severe inflammatory and morphological changes in oral mucosal tissues in chronic bacterial stress as opposed to controls (p < 0.001). Exposure to chlorhexidine significantly reduced the parameters of inflammation, including erythema, oedema, and cellular inflammation (p < 0.05). Nevertheless, structural changes, including epithelial thinning, collagen disorganisation, and decreased fibroblast density, were still present.

Conclusion: There are chronic polymicrobial stress conditions that lead to serious inflammatory and structural alterations of the oral cavity mucosa. Although chlorhexidine is effective in treating inflammation, it does not fully restore tissue architecture. These findings demonstrate that the balance between antimicrobial therapy and maintenance of tissue integrity must be established.