Salivary estimation of copper, iron, zinc and manganese in oral submucous fibrosis patients: A case-control study

Background: Trace elements (TEs) are required for physiological functioning and alterations are noted in potentially malignant disorders and oral cancer. These TEs are used in early diagnosis, treatment and also as an indicator of disease progress and prognosis. Aims: To estimate the TEs such as copper (Cu), zinc (Zn), iron (Fe), manganese (Mn) and Cu/Zn ratio in the saliva of oral submucous fibrosis (OSF) patients and controls. Settings and Design: The hospital-based study was conducted to estimate salivary TEs using atomic absorption spectrometry (AAS) in 60 individuals. Methods and Material: 5 ml saliva was collected from OSF cases (n=30) and controls (n=30) and was centrifuged and prepared by using the Wet Ashing method. The TEs were estimated in parts per million (ppm) by using AAS. Statistical Analysis Used: The data obtained was statistically analyzed using non parametric tests such as Mann Whitney U and Kruskal Wallis tests. Results: Significant difference in the mean salivary Zn, Mn and Fe levels in OSF when compared to that of controls. Mean salivary Cu levels were increased and Cu/ Zn ratio was decreased in OSF when compared to the controls. Conclusions: To conclude TEs play a role in the pathogenesis and progression of OSF. Betel quid and areca nut chewing habits are frequently associated with OSF and alters the salivary TE levels. Concerted efforts would, therefore, help in early detection, management and monitoring the efficacy of treatment.