saliva and salivary analysis
TRANSCRIPT
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
24
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