Aim: The present study was conducted to test the salivary levels of Cu, Zn, Fe, and Cu/Zn ratio in oral submucous fibrosis (OSF) patients.
Materials and methods: Thirty-eight patients, aged 18–60 years who were clinically diagnosed with OSF, were considered as cases (group A). Thirty-eight patients without any signs of OSF were considered as controls (group B). History of tobacco habits, both smoking and chewing, was recorded. Salivary trace elements were analyzed using atomic absorption spectrometry and a differential pulse anodic stripping voltmeter (DPASV). Statistical Package for the Social Sciences (SPSS, Version 23; Chicago Inc., Illinois, USA) was used for analysis of data.
Results: Significant differences were noted between cases and controls. While Zn and Fe levels were decreased in cases, copper levels and copper/zinc ratio were enhanced in OSF affected individuals.
Conclusion: Trace elements in saliva showed significant difference between OSF cases and healthy counterparts and are thus regarded as possible predictors for diagnosis of oral submucous fibrosis.
Clinical significance: The current study results clearly suggest an interaction of trace elements with OSF. Trace elements in saliva can be considered as a reliable, noninvasive diagnostic marker in OSF patients. Early diagnosis of these lesions can facilitate the provision of prompt treatment by the clinicians, for successful reversal and treatment.
Prabhu SR, Wilson DF, Daftary DK, et al. Oral diseases in the tropics. 1st ed. New Delhi: Oxford; 1993.
Neville BW, Day TA. Oral cancer and precancerous lesions. CA Cancer J Clin 2002;52(4):195–215. DOI: 10.3322/canjclin.52.4.195.
Kanjani V, Rani A, Kanjani D. Salivary evaluation of trace elements in oral submucous fibrosis: an atom absorption spectroscopic study. J Med Sci Clin Res 2019;7(3):43–47. DOI: 10.18535/jmscr/v7i3.09.
Richart RM, Barron BA. A follow-up study of patients with cervical dysplasia. Am J Obstet Gynecol 1969;105(3):386–393. DOI: 10.1016/0002-9378(69)90268-3.
Lee CH, Ko YC, Huang HL. The precancer risk of betel quid chewing, tobacco use and alcohol consumption in oral leukoplakia and oral submucous fibrosis in southern Taiwan. Br J Cancer 2003;88(3): 366–372. DOI: 10.1038/sj.bjc.6600727.
Nayak S, Chandra S, Mehrotra D, et al. Effect of tobacco, alcohol, and smoking habits in oral precancer with histological proven epithelial dysplasia. J Oral Biol Craniofac Res 2012;2(3):159–162. DOI: 10.1016/j.jobcr.2012.10.008.
Khulbe G, Tantradi P, Ammanagi R, et al. Estimation of salivary copper, zinc, iron and copper to zinc ratio in oral submucous fibrosis patients and its comparison with healthy individuals. J Indian Acad Oral Med Radiol 2019;31(4):333–338. DOI: 10.4103/jiaomr.jiaomr_81_19.
Shaik P, Pachava S. The role of vitamins and trace elements on oral health: a systematic review. Int J Med Rev 2017;4(1):22–31. DOI: 10.29252/IJMR-040105.
Dey D, Thakkannavar SS, Kumar M, et al. Evaluation of salivary copper and zinc levels in oral submucous fibrosis patients. Int J Res Health Allied Sci 2016;2(2):35–37. http://ijrhas.com/htmlissue.php?id=34.
Hamada GS, Bos AJ, Kasuga H, et al. Comparative epidemiology of oral cancer in Brazil and India. Tokai J Exp Clin Med 1991;16(1):63–72. PMID: 1780908.
Indian Council of Medical Research, Bangalore. Three-year report of population-based cancer registries 2006–2008. Incidence and distribution of cancer. 2010.
Bouquot JE, Whitaker SB. Oral leukoplakia rationale for diagnosis and prognosis of its clinical subtypes or phases. Quintessence Int 1994;25(1):133–140. PMID: 8183979.
Koyama H. Trace elements: mechanistic action of anticarcinogenic action action. Nippon Rinsho 1994;54(1):52–58. PMID: 8587206.
Ames BN. Micronutrients prevent cancer and delay aging. Toxicol Lett 1999;28:102–103. DOI: 10.1016/s0378-4274(98)00269-0.
Ayinampudi BK, Narsimhan M. Salivary copper and zinc levels in oral pre-malignant and malignant lesions. J Oral Maxillofac Pathol 2012;16(2):178–182. DOI: 10.4103/0973-029X.98452.
Maher R, Lee AJ, Warnakaluasuriya KA, et al. Role of areca nut in the causation of oral submucous fibrosis: a case control study in Pakistan. J Oral Pathol Med 1994;23(2):65–69. DOI: 10.1111/j.1600-0714.1994.tb00258.x.
Borle RM, Borle SR. Management of oral submucous fibrosis: a conservative approach. J Oral Maxillofac Surg 1991;49(8):788–791. DOI: 10.1016/0278-2391(91)90002-4.
Chadda RK, Sengupta SN. Tobacco use by Indian adolescents. Tob Induc Dis 2002;1(1):8. DOI: 10.1186/1617-9625-1-8.
Sinor PN, Gupta PC, Murti PR, et al. A case-control study of oral submucous fibrosis with special reference to the etiologic role of areca nut. J Oral Pathol Med 1990;19(2):94–98. DOI: 10.1111/j.1600-0714.1990.tb00804.x.
Pindborg JJ, Murti PR, Bhonsle RB, et al. Oral submucous fibrosis as a precancerous condition. Scand J Dent Res 1984;92(3):224–229. DOI: 10.1111/j.1600-0722.1984.tb00883.x.
Ahmad MS, Ali SA, Ali AS, et al. Epidemiological and etiological study of oral submucous fibrosis among gutkha chewers of Patna, Bihar, India. J Indian Soc Pedod Prev Dent 2006;24(2):84–89. DOI: 10.4103/0970-4388.26022.
Shetty SR, Babu S, Kumari S, et al. Role of serum trace elements in oral precancer and oral cancer–a biochemical study. J Cancer Res Treat 2013;1:1–3. DOI: 10.12691/jcrt-1-1-1.
Balpande AR, Sathawane RS. Estimation and comparative evaluation of serum iron, copper, zinc and copper/zinc ratio in oral leukoplakia, submucous fibrosis and squamous cell carcinoma. J Indian Acad Oral Med Radiol 2010;22(2):73–76. DOI: 10.5005/jp-journals-10011- 1018.
Poo JL, Rosas-Romero R, Montemayor AC, et al. Diagnostic value of the copper/zinc ratio in hepatocellular carcinoma: a case control study. J Gastroenterol 2003;38(1):45–51. DOI: 10.1007/s005350300005.
Toke GB, Dhamne BK. A study of serum copper, serum zinc and Cu/Zn ratio as diagnostic and prognostic index in cases of head, neck and face tumors. Indian J Pathol Microbiol 1990;33(2):171–174. PMID: 2391150.
Haddad NS, Haddad HH, Al-Elwee WM. Diagnostic values of copper, zinc and copper/zinc ratio compared to histopathological examination in patients with breast tumors. Basrah J Surg 2010;16(2):107–110. DOI: 10.33762/bsurg.2010.55455.