Chlorhexidine vs. Cetylpyridinium chloride: Impacts on salivary biomarkers linked to early oral squamous cell carcinoma detection

Abstract

Objective: This study aimed to evaluate the effects of chlorhexidine (CHX) and cetylpyridinium chloride (CPC) mouthwashes on salivary biomarkers associated with early detection of oral squamous cell carcinoma.

Method: The research investigated how daily use of chlorhexidine (CHX) and cetylpyridinium chloride (CPC) affects salivary biomarkers, which help detect early OSCC. The study included 150 participants who received equal distribution between the CHX and CPC groups and a control group for 14 days of observation. The researchers evaluated inflammatory cytokines IL-6 and IL-8, TNF-α and MMP-9 and oxidative stress markers ROS, MDA and TAC in saliva samples taken at three time points.

Result: The use of CHX led to a significant decrease in pro-inflammatory cytokines and MMP-9 levels and improved oxidative stability through reduced ROS and MDA and elevated TAC levels. The biochemical changes from CPC treatment were similar to those from CHX but at a lower intensity. The control group showed no important changes in biomarkers. The study results showed CHX produces more extensive and stronger changes in all measured biomarkers.

Conclusion: The study demonstrates that using antiseptic mouthwashes containing CHX for routine oral care will create detectable biochemical changes, which could hide early signs of OSCC in saliva tests. The implementation of pre-sampling protocols and washout periods becomes necessary to maintain accurate diagnostic results in clinical practice and research settings.