Salivary MMP-9 as a Biomarker for the Diagnosis of Oral Potentially Malignant Disorders and Oral Squamous Cell Carcinoma.

OBJECTIVE: To compare the salivary MMP - 9 concentration among subjects with oral squamous cell carcinoma (OSCC), oral potentially malignant disorders (OPMD), tobacco users, and control groups. MATERIALS AND METHODS: A total of 88 subjects were enrolled and divided into four study groups viz., OSCC (n=24), OPMD (n=20), tobacco habits (n=22), and healthy controls (n=22). All subjects gave unstimulated saliva samples for the evaluation MMP - 9 by ELISA kit. Demographic information like age, gender, type of tobacco, and duration of the habit were recorded. RESULTS: Subjects with OSCC and OPMD had significantly higher mean MMP-9 levels than subjects with tobacco habits and control groups (P<0.001). Also, poorly differentiated OSCC group had significantly higher mean saliva MMP-9 than moderate and well-differentiated OSCC. The optimal cut-off point was 214.37 ng/mL with a sensitivity of 100% and specificity of 59% for OSCC versus the control group. The optimal cut-off point was as 205.87 ng/mL with a sensitivity of 100% and a specificity of 54% for OPMD versus the control group. CONCLUSION: The data obtained from this study indicated that OSCC and OPMD had an increased level of salivary MMP-9. Salivary MMP-9 could be a useful, non-invasive adjunct technique in the diagnosis, treatment, and follow-up of OSCC and OPMD. 
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Estimation of salivary cortisol among subjects undergoing dental extraction.

BACKGROUND: Dental procedures can be stressful and studies have shown that salivary cortisol is elevated during such procedures. Our study aimed to evaluate saliva cortisol levels among the subjects who underwent dental extractions and to compare it with that of the controls. The secondary objective of the study was to evaluate any correlation between salivary cortisol and hemodynamic parameters. MATERIAL AND METHODS: We conducted this clinical study among subjects, who were indicated for dental extraction. Saliva samples from the subjects in the study group were collected before and after (10 mins) the dental extraction. Hemodynamic parameters like heart rate, systolic (SBP) and diastolic blood pressure (DBP) and oxygen saturation (Sp O2) were measured 10 minutes prior to the dental extraction and after completion of the extraction by a single trained examiner. Salivary cortisol was estimated by solid phase enzyme-linked immunosorbent assay (ELISA). RESULTS: A total of 31 subjects in the study group and 24 subjects in control group have participated in this study. The mean salivary cortisol concentration was significantly higher after extraction (27.94±7.94) than before extraction (24.67±8.31) in the study group (P<0.001). No significant correlations were seen between salivary cortisol concentration and hemodynamic parameters except for diastolic blood pressure after extraction. CONCLUSIONS: Dental extractions and local anaesthetic procedures can induce stress in subjects. Dental care providers should try to minimise the subject's anxiety and stress to the maximum extent. Key words:Cortisol, dental, extraction, saliva, stress.