SALIVA AND SALIVARY ANALYSIS

ASHISH RANGHANI

PG PART 1

GDCH, AHMEDABAD

Under guidance of

Dr. J.S SHAH

PROFESSOR AND HEAD

ORAL MEDICINE AND RADIOLOGY

GDCH

DATE- 06/04/2016

CONTENTS•Introduction

•Salivary gland anatomy

•Mechanism of saliva formation

•Composition of saliva• Organic components

• Inorganic components

•Volume

•Functions of saliva

•Properties of saliva

•Method of collecting saliva & how to measure salivary pH

•SALIVA : A DIAGNOSTIC FLUID

DEFINITION

“Saliva is a clear, watery fluid, secreted into mouth by major and minor salivary glands & oral mucous gland that function in testing, chewing and swallowing of food.

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In general, healthy adults produce 1000–1500 mL of saliva per day, at a rate of approximately 0.5 mL/min

MEDICAL PHYSIOLOGY BY SEMBULINGAM

TYPES OF SALIVARY GLANDS Salivary glands can be divided into Major and minor salivary glands.

Major – There are their pair of major glands namely:

Parotid.

Sub Mandibular

Sub lingual

Minor – These are distributed in mucosa and sub mucosa of the oral cavity:

Labial and Buccal glands.

Glossopalatine glands.

Palatine glands.

Lingual glands.

7/3/2017 4Human antomy by B.D chaurasia 4th edition

MAJOR SALIVARY GLAND 1

Parotid Submandibular Sublingual

Location In front and below of auricle above Massetermuscle

Submandibular fossa medial to lower part of mandible

Sublingual fossa

Duct name Stenson Whartons Bartholins

Secretion Mainly serous Mixed secretion Mainly mucous

Acinar cell type

Serous acini Mucous acini and serous acini

Mucous acini with serous demilunes

Human antomy by B.D chaurasia 4th edition

Largest of all glands

Purely serous gland which produces thin, watery, amylase rich saliva

It is irregular, wedge shaped, and unilobular.

Average Wt - 25gm

It is 5.8 cm in the craniocaudaldimension, and 3.4 cm in the ventral-dorsal dimension.

Located in the preauricular region and along the posterior surface of the mandible.

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PAROTID GLAND

Human antomy by B.D chaurasia 4th edition

Divided by the facial nerve into a superficial lobe and a deep lobe.

The superficial lobe

Overlying the lateral surface of the masseter,

Part of the gland lateral to the facial nerve.

The deep lobe

Medial to the facial nerve

Located between the mastoid process and the ramus of the mandible

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Stensen’s duct

5 cm in length

Anterior border of the gland

Runs anteriorly and downwards on the masseter b/w the upper and lower buccal branches of facial N.

At the anterior border of masseter it pierces

Buccal pad of fat

Buccopharyngeal fascia

Buccinator Muscle

It opens into the vestibule of mouth opposite to the 2nd upper molar.

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PAROTID DUCT

Superior border – Zygoma

Posterior border – External Auditory Canal

Inferior border – Styloid Process, Styloid Process musculature, Internal Carotid Artery, Jugular Veins

Anterior border – a diagonal line drawn from the Zygomatic to external auditory canal.

RELATION

Human antomy by B.D chaurasia 4th edition

SUB – MANDIBULAR GLAND

Second largest salivary gland

Produces 65-70% of total saliva output

The duct is called Wharton’s duct

Wharton’s duct exits on the floor of the mouth opposing the lingual surface of the tongue

Located in a depression on the lingual side of the mandibular body

Mixed secretion – mostly serous

Human antomy by B.D chaurasia 4th edition

SUB – LINGUAL GLAND

Smallest of the major glands

Produce less than 5% of total saliva output

Saliva delivered via the ducts of Bartholin

The Bartholin ducts exit on the base of the lingual surface of the tongue

Mixed secretion – mostly mucous

Human antomy by B.D chaurasia 4th edition

Located beneath the epithelium in almost all parts of the oral cavity

Labial

Buccal or molar glands

Palatal glands

Lingual mucus / tip and margins of tongue

Lingual serous / circumvallate and foliate glands

Not seen in gingiva & anterior part of hard plate.

Small groups of secretory units

Opening is via short ducts directly into the mouth .

They lack connective tissue capsule

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MINOR SALIVARY GLANDS

Human antomy by B.D chaurasia 4th edition

BASED ON SECRETIONS

• Parotid • Lingual serous Serous

• Lingual mucus• Buccal and palatal Mucus

• Submandibular • Sublingual and labial glands Mixed

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Fluid and electrolyte secretion is two step procedure.

1st step : Occures In acinar cells (primary saliva)

2nd step : Occurs In salivary ducts.

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MECHANISM OF SALIVA FORMATION

Hypotonic final

saliva into mouth

ORAL HISTOLOGY AND EMBRYOLOGY – ORBAN’S. 12TH EDITION

COMPOSITION OF SALIVA

MEDICAL PHYSIOLOGY BY SEMBULINGAM

parotid gland19%

submandibular gland65%

sublingual gland7%

minor salivary gland9%

Gland contribution of unstimulated salivary flow

parotid gland submandibular gland sublingual gland minor salivary gland

1. Lubrication

2. Antimicrobial

3. Growth factors

4. Mucosal integrity

5. Lavage / cleansing

6. Buffering

7. Remineralisation

1. Food preparation

2. Digestion

3. Taste

4. speech

FUNCTIONS OF SALIVA

PROTECTIVE FUNCTIONS : FOOD AND SPEECH RELATED FUNCTIONS:

The diagnostic role of Saliva, Journal section: Clinical and Experimental Dentistry, J Clin Exp Dent. 2011

PREPARATION OF FOOD FOR SWALLOWING

• Mucin of saliva lubricates thebolus and facilitates swallowing.

APPRECIATION OF TASTE • Taste is a chemical sensation.• Saliva dissolves the solid food

substances, so that the dissolved substances can stimulate the taste buds. The stimulated taste buds recognize the taste

ROLE IN SPEECH • By moistening and lubricating soft parts of mouth and lips, saliva helps in speech

MEDICAL PHYSIOLOGY BY SEMBULINGAM

Maltase • Maltase is present only in traces in human saliva and it converts maltose into glucose

Lingual Lipase

• Lingual lipase is a lipid-digesting enzyme. • It digests milk fats. • It hydrolyzes triglycerides into fatty acids and

diacylglycerol

Salivary Amylase

• Salivary amylase is a carbohydrate-digestingenzyme.

• It acts on cooked or boiled starch and converts it into dextrin and maltose.

• Optimum pH necessary for the activation of salivaryamylase is 6.

• Salivary amylase cannot act on cellulose

DIGESTIVE FUNCTION

MEDICAL PHYSIOLOGY BY SEMBULINGAM

CLEANSING AND PROTECTIVE FUNCTIONS

• Due to the constant secretion of saliva, themouth and teeth are rinsed and kept free offfood debris & foreign particles.

• Enzyme lysozyme of saliva kills some bacteria

• Proline-rich proteins & Lactoferrin has antimicrobial property and protect the teeth by stimulating enamel formation

• Immunoglobulin IgA has antibacterial and antiviral actions.

• Mucin present in the saliva protects the mouth by lubricating the mucus membrane of mouth.

MEDICAL PHYSIOLOGY BY SEMBULINGAM

MULTIFUNCTIONALITY

SalivaryFamilies

Anti-Bacterial

Buffering

Digestion

Mineral-ization

Lubricat-ion &Visco-elasticity

TissueCoating

Anti-Fungal

Anti-Viral

Carbonic anhydrases,Histatins

Amylases,Mucins, Lipase

Cystatins,Histatins, Proline-rich proteins,Statherins

Mucins, Statherins

Amylases,Cystatins, Mucins, Proline-rich proteins, Statherins

Histatins

Cystatins,Mucins

Amylases, Cystatins,Histatins, Mucins,Peroxidases

adapted from M.J. Levine, 1993

METHOD OF COLLECTING SALIVA

Spitting method

Suction method

Swab method

7/3/2017 SALIVA 22Burkit’s oral medicine 11th edition

• Avoid eating major meal within 60 minutes of sample collection.

• Avoid dairy products for 20 minutes before sample collection.

Avoid foods with high sugar or acidity, or high caffeine content, immediately before sample collection, since they may compromise the assay by lowering saliva pH and increasing bacterial growth.

• Rinse mouth with water to remove food residue before sample collection. Wait at least 10 minutes after rinsing before collecting saliva to avoid sample dilution.

7/3/2017 SALIVA 23

SALIVA COLLECTION METHODS

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25

SUBMANDIBULR /SUBLINGUAL

After blocking the parotid saliva secretion by placing a gauze pad at the orifice of the parotid ducts. Saliva can be collected from the floor of the mouth with a micropipette.

26

MINOR GLANDS

Minor gland secretions can be

collected by micropipette,absorbent

filter paper or strips from the inner

surface of lips,palate,or buccal

mucosa and quantitated by weight

differences or using a Peritron

device.

27

• First, fill your mouth with saliva and then swallow it. Repeat this step to help ensure that your saliva is clean. Then the third time, put some of your saliva onto the pH paper.

• The pH paper should turn blue. This indicates that your saliva is slightly alkaline at a healthy pH of 7.4. If it is not blue, compare the color with the chart that comes with the pH paper.

How to Perform the Saliva pH Test

• pH paper test using saliva represents the most consistent and most definitive physical sign of the ionic calcium deficiency syndrome ...

• The saliva pH of the non-deficient and healthy person is in the 7.5 to 7.1 slightly alkaline range.

• The range from 6.5 (weakly acidic) to 4.5 (strongly acidic)represents states from mildly deficient to strongly deficient, respectively.

• Most children are dark blue, a pH of 7.5. Over half of adults are green-yellow, a pH of 6.5 or lower, reflecting the calcium deficiency of aging and lifestyle defects.

• Cancer patients are usually a bright yellow, a pH of 4.5, especially when terminal."

CARIES ACTIVITY TESTS

Definition:

Increment of active lesions (new and recurrent

lesions) over a stated period of time.

Caries susceptibility:

Susceptibility (or resistence) of a tooth to a caries producing

environment.

Caries Activity Tests ,Journal of Dental Sciences ,Volume 1, Issue 3 ,October December, 2013

Principle involved: Estimation of the number of acidogenic and aciduric bacteria in the patient saliva by counting the number of colonies appearing on Tomato peptone agar plates (pH 5.0) after inoculation with a sample of saliva.

No of organisms

1-1000

1000-5000

5000-10,000

More than

10,000

Symbolic

designation

+

+

++

+++/++++

Degree of caries

activity suggested

Little or none

Slight

Moderate

Marked

LACTOBACILLUS COLONY COUNT TEST

•This test measures the ability of salivary microorganisms to form organic acid from a carbohydrate medium.

•The medium contains an indicator dye “Bromocresol green”, changes colour from green to yellow when pH changes from 5.4 to 3.8. Indirectly measures the number of both aciduric and acidogenic organisms in saliva.

SNYDER TEST

24 hrs 48 hrs 72hrs

Color : yellow yellow yellow

Caries activity: marked definite limited

Color : green green green

Caries activity: continue test continue test continue test

This test measures the activity of reductase enzyme present in salivary bacteria

The sample is mixed with fixed amount of diazo-resorcinol

The change in color after 15 min is taken as a measure of caries activity

REDUCTASE TEST

color Time score Caries activity

Blue

Orchid

Red

Red

pink

15min 1

15 min 2

15 min 3

Immediately 4

Immediately 5

Non conductive

Slightly conductive

Moderately conductive

Highly conductive

Extremely conductive

Principle involved: Measurement of amount of powdered enamel dissolved, when the patient’s saliva is mixed with glucose and powdered enamel.

•It is based on the fact that when glucose is added to saliva containing powdered enamel, organic acids are formed

•Organic acid decalcifies the enamel, resulting in an increase in the amount of soluble calcium

•The extend of increase of calcium is a direct measure of caries activity

FOSDICK CALCIUM DISSOLUTION TEST

• It is a modified Snyder test

•At the time of test 5 ml, tube of semisolid agar is removed from refrigerator but is not heated

•The patient is asked to spit unstimulated saliva directly in to the tube. Tube is incubated for 4 days.

ALBEN’S TEST

• Advantage is no collection of saliva is necessary• Valuable in evaluating caries activity in very young children• Principle is same as Snyder test• The oral flora is sampled by swabbing the buccal surface of

tooth with cotton.

SWAB TEST

Flow rate is determined by collecting paraffin stimulated saliva in a test tube over 5 min

Severely decreased flow is related to caries susceptibility

As salivary flow rate decreases viscosity increases

SALIVA FLOW TEST

Unstimulated whole saliva flow rates of <0.1 ml/min and

stimulated whole saliva flow rate’s of <1.0 ml/min are

considered abnormally low& indicative of marked

salivary hypofunction.

whole saliva flow rates increased is known as

hypersalivation (ptylism) / sialorrhoea

• Sialorrhea (drooling or excessive salivation) is defined as

saliva beyond the margin of the lip.

• This condition is normal in infants but usually stops by 15 to

18 months of age.

• Sialorrhea after four years of age generally is considered to be

pathologic.

SIALORRHEA

Sialorrhea: A Management Challenge,AMERICAN FAMILY PHYSICIAN, JUNE 1, 2004 / VOLUME 69

Neuromuscular/sensory

dysfunction

• Mental retardation

• Cerebral palsy

• Parkinson’s disease

• Stroke

Hypersecretion

• Inflammation (teething, oral-

cavity infection, rabies)

• Medication side effects

(anticonvulsants)

• Gastroesophageal reflux

• Toxin exposure (mercury vapor)

Anatomic

• Macroglossia (enlarged

tongue)

• Dental malocclusion

• Orthodontic problems

• Head and neck surgical

defects

ETIOLOGY OF SIALORRHEA

Xerostomia is a subjective sensation of a dry mouth which is a

common complaint among older patients during period of anxiety,

radiation therapy, immunological disorder which lead to increased

frequency of caries, candida infection, and dysphagia

Iatrogenic Drugs Local radiation Chemotherapy

• Diseases of the salivary glands • Sjogren’s syndrome • Sarcoidosis • HIV disease • Hepatitis C virus infection • Primary biliary cirrhosis • Cystic fibrosis • Diabetes mellitus

• Rare causes • Amyloidosis • Hemochromatosis• Wegener’s disease • Salivary gland agenesis

XEROSTOMIA

International journal of dental clinics volume 3 issue 2 apriljune 2011, xerostomia: an overview

• Anticholinergic agents: Atropine and Hyoscine• Anti-reflux agents: Omeprazole • Psychoactive agents: Amitriptyline, • Benzodiazepines, • Opioids• Antihistamines• Anti-hypertensive: • Alpha 1 antagonists: Terazosin, Prazosin• Alpha 2 agonists: Clonidine • Beta blockers: Atenolol, Propranolol

SALIVA : A DIAGNOSTIC FLUID

ADVANTAGES:

•Non-invasive

•limited training

•No special equipment

•potentially valuable for children and older adults

•cost-effective

•eliminates the risk of infection

•screening of large populations

• blood is still the gold standard for diagnostics of diseases and drugs, Saliva offers an alternative to serum as a biologic fluid for diagnostic purposes.

• The components of saliva act as a―mirror of the body’s health

42

IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)Volume 11, Issue 6 (Nov.- Dec. 2013), PP 96-99

The diagnostic role of Saliva, Journal section: Clinical and Experimental Dentistry, J Clin Exp Dent. 2011

CIRCADIAN CYCLE

• Salivary Flow attains its peak at the end of the AFTERNOON but goes down to almost zero during SLEEP

• The concentration of total proteins attains its peak at the end of the afternoon, while the peak production levels of sodium and chloride occur at the beginning of the morning.

Body Posture, Lighting, and Smoking

• During standing up or lying down higher and lower Salivary Flow respectively, than seated patients.

• There is a decrease of 30% to 40% in Salivary Flow of people that are blind or in the dark

• Smoking cause a temporary increase in unstimulated Salivary Flow

• As the Salivary Flow increases, the concentrations of total protein,

• sodium, • calcium, • chloride,• bicarbonate • pH increases to various levels, • whereas the concentrations of inorganic phosphate

and magnesium diminish

pH normal range of 6.2-7.6 with 6.7 average pH.

Maintenance of the pH by two mechanisms.

1. The flow of saliva eliminates carbohydrates that could be metabolized by bacteria and removes acids produced by bacteria.

2. Acidity from drinks and foods, as well as from bacterial activity, is neutralized by the buffering activity of saliva.

Physical examination

Sr no Normal value Increased Decreased

1 Amount1000 to 1500ml

Physiological: Exercise Physiological: • Stress, • dehydration, • high temperature

Pathological : • Aphous ulcer• ANUG• Periodontal disease • Pemphigus • Mercuric salt • Bismuth • Iodide • facial palsy• Down’s syndrome• Epilepsy • Psychic factor• Drugs: adrenaline, pilocarpine,

epinephrine

Pathological : • Nutritional deficiency• Diabetes,• Hypertension • Drugs: atropine,

promethazine, antiemetic, antihistaminic, antihypertensivechlorpromazine

• Radiation induced • Developmental

abnormalities of salivary gland, tumors

Srno Normal value Increased Decreased

1 Colortransparent

Cloudy- inflammationMilky- flow discontinuity

2 PH6.35 to 6.85

• Chronic generalized gingivitis• KIDNEY dysfunction• Bad breath

• Dental caries• Chronic generalized

periodontitis• gastroesophageal

reflux disease

3 Viscosity 0.82 forunsti 0.88 for sti

Dental caries

4 Salivary pressure Hypertrophy of masseteric musclesSialadenosis

Sr INORGANICCOMPONENTS

INCREASED DECREASED

1 Osmolality 40-100 mmol/kg

Damage, inflammation, allergy, hypersalivation

Shortage of blood

2 Na:K ratio Cushings disease & addisons disease

3 Thiocynate Smokers

4 Fluoride Sialadenosis High caries risk

5 Calcium Cystic fibrosis

6 Potassium 20-30mmol/L Cystic fibrosis

7 Sodium 136-146 mmol/L Hypertension, Sjogren synd, mumps, CMV, gout, allergy, irrardiation

Hypotension ,atherosclerosis,dehydration , vitB12deficiency, lithiumcarbonate

8 Chloride Sjogren synd, Cystic fibrosis

9 Bicarbonate 1-35 mmol/L

Sjogren syndrome

10 Phosphorous Cystic fibrosis Sjogren syndrome

Sr ENZYMES INCREASED DECREASED

1 Amylase • DIABETES,• Chewing• pilocarpine• Long standing

dietary habit (starch)

• Mumps

• Radiation, • Sjogren

syndrome,• anorexia,• β blocker

2 Catalase Periodontaldisease

3 Peroxidase Periodontaldisease

4 Lysozyme Sjogren syndrome,

5 Kallikren Salivary Malignant Tumour

6 Salivary prostaglandin

Major depressivedisorder

Sr

STEROIDS INCREASED

1 Cortisone Endocrinal disease

2 Cortisol Stress, Cushing Syndrome,Addisons disease,

3 Aldosterone

Crohn’sSyndrome

Sr No Immunological markers INCREASED

1 C-erb-2 Breast Ca

2 CA 125 Epithelial Ovarian Ca

3 PGE2 Cystic fibrosis,

4 P53 antibody SCC

5 IgA, IgG Sjogren syndrome, autoimmune dse, DIABETES

6 Lactoferrin Sjogren syndrome

7 B2 microglobulin Sjogren syndrome

8 Anti-Tick antibody Lyme disease

9 CD44 Head & Neck Ca

10 CK-MB Acute MI

BACTERIOLOGY

This organisms detect in salivaStreptococcus salivaris, streptococcus mutans, lactobacilli, proteus, nocardia, h. pylori, klebsiella

Virology

Human herpis virus 8, cytomagalo virus, and epistein barrvirus

• Hereditary disease Cystic fibrosis

• Autoimmune disease sjogren symdrome

• Malignancy• Infection

HIVDENGUEHEPETITIS A & BHSV 1

• Dental caries and periodontal disease• Monitoring of levels of hormones • Monitoring of levels of drugs.

Analysis of saliva for the diagnosis of following

Hereditary diseases Cystic

fibrosis (CF)

In the submandibuar saliva

Elevations in

• electrolytes (sodium, chloride,

calcium, and phosphorus),

• Urea and uric acid,

• Total protein and

• Lipid

SJÖGREN’S SYNDROME

• Serum chemistry can

demonstrate polyclonal

hypergammaglobulinemia

• Elevated levels of

• Rheumatoid factor,

• Antinuclear antibody,

• anti-SS-A, and anti-SS-B

antibody.

• Increased concentrations of

sodium and chloride, IgA, IgG,

lacoferrin, and albumin

• decreased concentration of

phosphate

MALIGNANCY

• The mRNA levels for specific proteins are elevated in the saliva of head and neck cancer patients.

• The p53 antibodies detected in the saliva of patients diagnosed with oral squamous cell carcinoma (SCC)

• Elevated levels of salivary defensin-1 were found to be indicative of the presence of oral SCC.

• CA 125 is a tumor marker for cancer. Elevated salivary levels of CA 125 were detected in patients with untreated breast cancer

Infectious diseases

• Dengue is a mosquito-transmitted viral disease. Salivary levels of anti-dengue IgMand IgG demonstrated

• HIVHIV Antibody was detected by ELISAand Western blot assay.

• Acute hepatitis A (HAV) and hepatitis B(HBV) - IgM antibodies in saliva.

• DNA in saliva is a useful method for theearly detection of HSV-1 reactivation inpatients with Bell’s palsy.

• In the children infected with Shigellarevealed higher titers of anti-Shigatoxin antibody

Dental Caries and Periodontal Disease

• High numbers of S. Mutansand Lactobacillus indicate a shift in oral microflora from healthy to more cariogenic

• Proteins with high amounts of proline (PRP1 and PRP3), histatin1 and statin decrease in high-caries patients

• DNA can easily be isolated from oral epithelial cells, collected by use of a buccal swab

The Monitoring of Hormone Levels

• Increased aldosterone levels were found in saliva primary aldosteronism (Conn’s syndrome)

• Elevated salivary estriol increased risk of preterm birth.

• Insulin - Insulin can be detected in saliva, a positive correlation between saliva and serum insulin levels following a glucose tolerance test was reported for healthy subjects, diabetic patients.

Saliva can be analyzed as part of the evaluation of endocrine function.

Serum and salivary levels of protein hormones are not well-correlated. These hormones are too large to reach saliva by means of passive diffusion across cells or by ultrafiltration

DETECTION OF DRUGS

• Saliva is also useful for the monitoring of anti-epileptic drugs and anti-cancer drugs

• Other drugs that can be identified in saliva are

• amphetamines, • barbiturates,• benzodiazepines, • cocaine, • phencyclidine (PCP), and • opioids.

• Nicotine saliva can be used to monitor tobacco smoking and exposure to tobacco smoke.

• Monitoring level of salivary nicotinine has proven useful in monitoring compliance with smoking cessation programs

BIOMARKERS:

Biomarkers are defined as cellular, biochemical and molecular characteristics by which normal/abnormal processes can be recognized and/or monitored.

Salivary pH: A diagnostic biomarker, J Indian Soc Periodontol. 2013 Jul-Aug; 17(4): 461–465

CLASSIFICATION OF SALIVARY BIO MARKERS:

◘PROTEOMIC

◘GENOMIC

◘MICROBIAL

SALIVARY/ORAL FLUID BIOMARKERS POSSIBILITIES OF USEDNA Standard genotyping

Genetic information of the hosting human bodyBacterial infection (oral microbes in the mouth) Diagnosing carcinomas of head & neckForensics

mRNA Information on transcription rates

RNA Viral/bacterial identification

Proteins Genetic informationTranslational regulation Diagnosing periodontitisDental caries

Immunoglobulin Diagnosing viruses

Metabolites Diagnosing periodontitis

Various salivary biomarkers in oral cancer

• IL-1, IL-6• IL-8, TNF-a• Actin, myosin• p53 Autoantibodies• Telomerase• Salivary mRNA• Salivary IL-8 mRNA• and protein

• DNA obtained from saliva using phenol chloroform

extraction method for the purpose of forensic identification.

• Two STRs namely Amelogenin (AMG) and von willibrand

factor (vWF) for assessing gene amplification.

• AMG is a sex determining gene which is located on the X

and the Y chromosome.

• The vWF gene is located at the tip of the short arm of

chromosome 12 and is utilized in routine forensic DNA

profiling

SALIVARY DNA FOR SEX DETERMINATION

Journal of Forensic Medicine & Toxicology Vol. 29 No. 1, January - June 2012, Parul Khare

SEX DETERMINATION FROM BUCCAL MUCOSA SCRAPES

• Determination of sex from buccal smear were given by Moore and

Barr

• Barr body can also be obtained from buccal smears, pulp tissue,

vaginal smears & hair follicle

• It is one of the simple & easiest method to identify sex of the

individual

• In this method sex of the individual is identified using nuclear sex

chromatin method

Role of barr bodies obtained from oral smears in the determination of sex, Indian j Dent Res 2004;15:5-7

Method

• Sample obtain using metal spatula from buccal mucosa • Smeared in the frosted slide• Fix in ethyl alcohol 95% for 10 to 20 min • Rinsed in distilled water • Stained with papanicolaou stain & mounted• Compound microscope under oil immersion use to

visualize the slide

Results found to have 1.14% positivity for males & 39.29% for females

Thus Barr-body plays a vital role in identification

REFERENCES

1) Human antomy by B.D chaurasia 4th edition2) MEDICAL PHYSIOLOGY BY SEMBULINGAM3) ORAL HISTOLOGY AND EMBRYOLOGY – ORBAN’S. 12TH EDITION 4) Burkit’s oral medicine 11th edition5) IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)

Volume 11, Issue 6 (Nov.- Dec. 2013), PP 96-996) The diagnostic role of Saliva, Journal section: Clinical and Experimental

Dentistry, J Clin Exp Dent. 20117) Salivary pH: A diagnostic biomarker

J Indian Soc Periodontol. 2013 Jul-Aug; 17(4): 461–4658) Saliva Composition and Functions, The Journal of Contemporary Dental

Practice, Volume 9, No. 3, March 1, 20089) Caries Activity Tests ,Journal of Dental Sciences ,Volume 1, Issue 3 ,October

December, 201310) Journal of Forensic Medicine & Toxicology Vol. 29 No. 1, January - June 2012,

Parul Khare11) International journal of dental clinics volume 3 issue 2 april

june 2011, xerostomia: an overview12) Role of barr bodies obtained from oral smears in the determination of sex

Indian j Dent Res 2004;15:5-7

Thank you