Evaluation of the Cytotoxic Effect of Chlorhexidine on the Healing Process of Oral Surgeries: An Integrative Literature Review
Lara Caroline Moura de Goes *
Faculty of Dentistry, University of Fortaleza, 587 Dr. Valmir Pontes Avenue, Edson Queiroz District, Fortaleza, Ceará, 60812-020, Brazil.
Thobias Emanuel Lima Saldanha
Faculty of Dentistry, University of Fortaleza, 587 Dr. Valmir Pontes Avenue, Edson Queiroz District, Fortaleza, Ceará, 60812-020, Brazil.
Andressa Nunes de Sá Roriz
Faculty of Dentistry, University of Fortaleza, 587 Dr. Valmir Pontes Avenue, Edson Queiroz District, Fortaleza, Ceará, 60812-020, Brazil.
Bruna Fernandes Moura
Faculty of Dentistry, University of Fortaleza, 587 Dr. Valmir Pontes Avenue, Edson Queiroz District, Fortaleza, Ceará, 60812-020, Brazil.
Lays Araújo Oliveira Veras
Faculty of Dentistry, University of Fortaleza, 587 Dr. Valmir Pontes Avenue, Edson Queiroz District, Fortaleza, Ceará, 60812-020, Brazil.
Vitória Caroline Fernandes Bitu
Faculty of Dentistry, University of Fortaleza, 587 Dr. Valmir Pontes Avenue, Edson Queiroz District, Fortaleza, Ceará, 60812-020, Brazil.
Alinne Patierry Oliveira Pacífico Feitosa
Faculty of Dentistry, University of Fortaleza, 587 Dr. Valmir Pontes Avenue, Edson Queiroz District, Fortaleza, Ceará, 60812-020, Brazil.
Ana Patrícia Souza de Lima Alcântara
Faculty of Dentistry, University of Fortaleza, 587 Dr. Valmir Pontes Avenue, Edson Queiroz District, Fortaleza, Ceará, 60812-020, Brazil.
Marcelo Victor Sidou Lemos
Faculty of Dentistry, University of Fortaleza, 587 Dr. Valmir Pontes Avenue, Edson Queiroz District, Fortaleza, Ceará, 60812-020, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Healing after oral surgeries can be affected by infection and plaque accumulation. This study evaluated the cytotoxic effect of chlorhexidine through an integrative literature review. A total of 44 articles were found in PubMed, of which 5 were selected using the keywords “Chlorhexidine,” “healing,” and “soft tissue,” including randomized clinical trials and animal studies published in English over the last 10 years. Chlorhexidine reduces bacterial load and controls infection, especially in the early healing phase, but prolonged use can cause tooth staining, taste alteration, tartar formation, and cytotoxicity to fibroblasts and keratinocytes, potentially delaying tissue repair. Alternatives such as PHMB and antioxidant gels have shown similar efficacy with lower cytotoxicity. Safer and effective substances are still needed to optimize healing and clinical outcomes. Chlorhexidine is an important solution for plaque removal and inflammation reduction; however, it also acts as a cytotoxic agent, exerting a negative effect on fibroblasts and keratinocytes, which are essential for the healing of surgical wounds. Based on the selected studies, its use in the context of surgical wound healing should be prescribed with caution due to the potential adverse effects of this substance.
Keywords: Healing, chlorhexidine, cytotoxicity, oral surgery