The Effect of Hookah Use on Buccal Mucosa: Evaluation of Repair Index

Document Type: Research Articles

Authors

1 Department of Oral Medicine, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.

2 Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University,Tehran, Iran.

3 Dentist, Tehran, Iran

Abstract

Background and aim: Cigarettes, hookah, and tobacco are the most important etiologic factors for oral cancers
and dysplastic lesions. This study was undertaken to determine the correlation between hookah use and the percentage
of cells with micronucleus, karyorrhexis, karyolysis, and broken egg in the buccal mucosa; and secondly to compare
hookah user and non-user in terms of repair index. Materials and methods: The present historical cohort study was
carried out on 72 samples taken from 36 hookah users and 36 control subjects. Smear samples were obtained from
participants’ buccal mucosa for cytological evaluation using Papanicolaou technique. Then, the percentages of cells
with micronucleus, karyorrhexis, karyolysis, and broken egg were recorded and the repair index was calculated. Data
were analyzed using Mann-Whitney U test. Results: A total of 72 samples taken from 36 hookah users and 36 control
subjects were evaluated. The means of micronucleus scores in the buccal mucosa cells of hookah users and controls
were 10.7±2.6 and 5.8±2.0, the karyorrhexis scores in the hookah users and controls were 0.1±0.06 and 0.04±0.06,
and the karyolysis scores in hookah users and controls were 0.16±0.05 and 0.08±0.06, respectively. These differences
were statistically significant between hookah users and controls (P<0.001). The broken egg score was 0.66±0.07 for the
hookah users and 0.03±0.04 for the control group, revealing a statistically significant difference (P<0.036). Finally, the
repair index values were 0.03±0.01 and 0.05±0.13 in hookah users and controls, respectively. This difference was also
significant (P<0.026). Conclusion: The percentages of cells with micronucleus, karyorrhexis, karyolysis, and broken
egg in the buccal mucosa of hookah users were significantly higher than those in control group; in addition, the repair
index of the buccal mucosa cells in hookah users was significantly lower than that in the control group.

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