Comparative Analysis of Salivary Trace Elements and Copper-to-Zinc Ratio in Oral Submucous Fibrosis Patients and normal Individuals

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Dr. Rashmi Kiran Ekka, Dr. Rachana Gandhi, Dr Paawan Sharma, Dr Varun Sachan, Dr Anuj Kishor Shukla, Dr. Sachin B Mangalekar, Dr. Kapil Paiwal, Dr. Bhumika J Patel


Introduction: Oral submucous fibrosis (OSMF) is a malignant, chronic condition of the oral mucosa. It has been hypothesized that an insufficiency or excess of trace elements like copper (Cu), zinc (Zn), or iron (Fe) contributes significantly to OSMF's pathophysiology.

Objectives: Salivary copper, zinc, iron, and copper-to-zinc ratio were estimated and compared between OSMF patients and healthy controls in this research.”

Materials and methods:

In this cross-sectional research, we recruited a total of 100 people: 50 people with OSMF (the experimental group) and 50 people without the disorder (the control group). Atomic absorption spectroscopy was used to determine the concentrations of copper, zinc, and iron in the collected saliva samples. The copper-to-zinc ratio is a derived parameter that was computed.


“The results revealed significantly higher levels of salivary copper in the OSMF group compared to the control group (p < 0.001). Conversely, salivary zinc levels were significantly lower in the OSMF group (p < 0.001). Salivary iron levels did not show significant differences between the two groups (p = 0.237). The copper-to-zinc ratio was significantly elevated in OSMF patients compared to healthy individuals (p < 0.001).”


Individuals with OSMF were shown to have an imbalance between copper and zinc in their saliva, as well as a greater ratio of copper to zinc. This suggests that these trace components may play a role in OSMF's origin. Further research is needed to elucidate the underlying mechanisms, although it seems that copper, zinc, iron, and the copper-to-zinc ratio in saliva may have significant diagnostic and prognostic repercussions for OSMF.

Keywords: Oral submucous fibrosis, trace elements, salivary copper, salivary zinc, salivary iron, copper-to-zinc ratio, atomic absorption spectroscopy.

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