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The buccal micronucleus cytome (BMNCyt) assay is a minimally invasive cytogenetic technique to evaluate genomic damage, cell differentiation and cell death in human studies. This assay has been successfully applied in the biomonitoring of occupational or environmental exposure to genotoxic agents by inhalation or by direct contact. Possible clinical applications in prescreening and in the follow-up of oral diseases and cancer have been also envisaged. The micronucleus (MN) assay in buccal cells, as a surrogate tissue, to evaluate risk/susceptibility for cancer and other degenerative diseases deserves further investigation. A standardized protocol for buccal cell collection, slide preparation and scoring of cell types and nuclear anomalies has been established. Detailed scoring criteria and a comprehensive gallery of photomicrographs for cellular and nuclear scoring have also been developed to complement the protocol. Validation studies through interlaboratory scoring exercises have shown that current criteria are sufficiently robust to obtain consistent results concerning the identification of differentiated cells and MN and nuclear buds within them, which represent the main biomarkers for the evaluation of chromosomal damage. Improvements in scoring and analysis methods and further investigation about the biological significance of other BMNCyt biomarkers associated with cell differentiation and cell death are also needed in order to define their role and justify their application in human biomonitoring studies.

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