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Cytotoxicity and genotoxicity of whitening toothpastes in buccal mucosal cells: a randomized controlled trial

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Abstract

Objectives

To assess genotoxic and cytotoxic effect of commercially available toothpastes with the different whitening ingredients.

Materials and methods

In vivo assessment of cytotoxicity and genotoxicity of whitening toothpastes with different ingredients using a buccal micronucleus cytome assay (BMCyt assay) comprised 199 participants randomly divided into ten groups based on used whitening or control/conventional toothpaste. The exfoliated buccal mucosal cells were collected, stained, and microscopically evaluated at baseline (T0), 30 days (T1), and 60 days (T2) after the beginning of treatment and 30 days after completing treatment (T3). Statistical evaluation was performed by repeated-measures analysis of variance (two-way ANOVA), Tukey’s test, and multiple regression analysis.

Results

The genotoxic parameters showed no biologically significant changes in any of the observed period for the tested toothpastes, while cytotoxic parameters (number of cells with karyorrhexis and condensed chromatin) showed statistically significant difference (P < 0.05) among evaluation periods for the three peroxide-containing toothpastes.

Conclusions

Peroxide-containing whitening toothpastes exhibit an increase in certain cytotoxic parameters only during the application period, which return to control values after the cessation of application.

Clinical significance

Whitening toothpastes show no genotoxic effect, while peroxide-containing whitening toothpastes may present significant increase of cytotoxicity (measured by the number of karyorrhexis and condensed chromatin) during the application period. However, these changes observed in clinical conditions cannot be considered significant.

Trial registration

ClinicalTrials.gov: NCT04460755.

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Funding

This study was funded by the researchers themselves.

Author information

Author notes

  1. Nada Zorica Vladislavic, Jasen Vladislavic, Ivana Franic and Antonija Tadin contributed equally to the work.

Authors and Affiliations

  1. Dental Polyclinic Split, A.G. Matosa 2, 21000, Split, Croatia

    Nada Zorica Vladislavic

  2. Department of Pulmonology, Clinical Hospital Centre Split, 21000, Split, Croatia

    Jasen Vladislavic

  3. 5Th Gymnasium “Vladimir Nazor” Split, 21000, Split, Croatia

    Ivana Franic

  4. Department of Restorative Dental Medicine and Endodontics, Study of Dental Medicine, School of Medicine, University of Split, 21000, Split, Croatia

    Antonija Tadin

  5. Department of Maxillofacial Surgery, Clinical Hospital Centre Split, 21000, Split, Croatia

    Antonija Tadin

Authors
  1. Nada Zorica Vladislavic
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  3. Ivana Franic
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  4. Antonija Tadin
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Nada Zorica Vladislavic, Jasen Vladislavic, Ivana Franic, and Antonija Tadin. The first draft of the manuscript was written by Nada Zorica Vladislavic and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Nada Zorica Vladislavic.

Ethics declarations

Ethics approval and consent to participate

All participants were introduced to the background and the study’s aim and gave their informed consent in writing before inclusion in the investigation. The study protocol was approved by the Ethics Committee of School of Dental Medicine, University of Zagreb (No. 05-PA-30–9/2018), and Ethics Committee of School of the Medicine, University of Split (No. 2181–198-03–04-17–0063; No. 2181–198-03–04-20–0067), who also confirmed that the study was in full accordance with ethical principles including the World Medical Association Declaration of Helsinki (version 2013).

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Consent to submit has been received from all authors.

Conflict of interest

The authors declare no competing interests.

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Highlights

• All tested whitening toothpastes showed no genotoxic effect.

• Peroxide-containing toothpastes revealed increased cytotoxicity (number of cells with karyorrhexis and condensed chromatin) for the application period only.

• In clinical conditions, the obtained changes cannot be considered significant.

• Generally, whitening toothpastes containing abrasives, peroxides, and/or enzymes and charcoal are safe for usage.

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Vladislavic, N.Z., Vladislavic, J., Franic, I. et al. Cytotoxicity and genotoxicity of whitening toothpastes in buccal mucosal cells: a randomized controlled trial. Clin Oral Invest 27, 6245–6259 (2023). https://doi.org/10.1007/s00784-023-05241-6

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  • DOI: https://doi.org/10.1007/s00784-023-05241-6

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