ABSTRACT
Background: Leukemia is a fatal disease. The oral manifestations of the leukemias occur early in the course of the disease and these oral features can at times act as a diagnostic indicator. Saliva has been used as a diagnostic aid in a number of systemic diseases. Materials and Methods: In our study, samples of unstimulated saliva of 30 leukemia patients who were not on chemotherapy were collected and analyzed for salivary amylase and total protein. The oral manifestations and radiographic changes (OPG) were recorded. The correlation between the oral manifestations and the salivary components (salivary amylase and total protein) was assessed for prognostic significance. Results: In the present study when the mean values of salivary amylase (1280±754 U/ml) and total protein (647.2±320.7 mg%) were compared with that in control subjects. There was a statistically significant difference for amylase levels (P<.05). On intraoral examination the study subjects showed pallor, gingivitis, gingival enlargement, petechiae, and ecchymosis. On the OPG, the radiographic features included generalized rarefaction of bone (20%), thinning of lamina dura (3.4%), generalized alveolar crest bone resorption (30%), thinning of walls of alveolar crypts (6.7%), besides others, e.g., periapical abscess (10%). Conclusions: The saliva of leukemic patients demonstrated obvious changes in composition. A rise in salivary amylase and total protein levels was evident, with the increase in amylase levels being statistically significant.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Alveolar Bone Loss/etiology , Alveolar Bone Loss/diagnostic imaging , Amylases/analysis , Case-Control Studies , Child , Child, Preschool , Ecchymosis/etiology , Female , Gingival Hypertrophy/etiology , Gingivitis/etiology , Humans , Jaw Diseases/etiology , Jaw Diseases/diagnostic imaging , Leukemia/complications , Leukemia/metabolism , Leukemia, Lymphocytic, Chronic, B-Cell/complications , Leukemia, Lymphocytic, Chronic, B-Cell/metabolism , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/complications , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism , Leukemia, Myeloid, Acute/complications , Leukemia, Myeloid, Acute/metabolism , Male , Middle Aged , Mouth Diseases/etiology , Periapical Abscess/etiology , Periapical Abscess/diagnostic imaging , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Precursor Cell Lymphoblastic Leukemia-Lymphoma/metabolism , Purpura/etiology , Radiography, Panoramic , Saliva/enzymology , Salivary Proteins and Peptides/analysis , Young AdultABSTRACT
Background and Objectives: Lichen planus is a relatively common chronic inflammatory disease of oral mucosa and skin. Cortisol, also called as "stress hormone", has been used as an indicator in various stress evaluation studies. Salivary cortisol measurement is an indicator of free cortisol or biologically active cortisol in human serum and provides noninvasive and easy technique. Recent studies have been conflicting, and hence, in the present study, evaluation of salivary cortisol levels and psychosocial factors in oral lichen planus (OLP) patients was done. Materials and Methods: A total of 30 patients with clinically and histopathologically proven cases of OLP, along with the age and sex-matched healthy controls were included in the study. Samples of stimulated saliva were collected, centrifuged and analyzed for the level of cortisol with cortisol enzyme linked immunosorbent assay. Psychosocial factors of study and control groups were measured by depression anxiety and stress scale. Student's t-test was used to compare the psychological factors and salivary cortisol levels between patients with the OLP and the control group. Results: Irrespective of sex, significantly higher depression (83.4 ± 15.4%), anxiety (80.5 ± 11.3%), and stress (94.2 ± 6.2%) scores were observed in OLP patients compared to controls. Increased cortisol levels were observed among 17 (56.6%) OLP patients in the study group. A positive correlation was found between psychological factors and salivary cortisol levels in the OLP patients. The values of Pearson's correlation coefficient "r", between depression, anxiety, and stress with salivary cortisol was: +0.42,S; +0.27,NS; and +0.65,HS, respectively among the study group.