Assessment of tissue copper level in oral submucous fibrosis patients

Background: Oral submucous fibrosis (OSMF) is a precancerous condition with a high risk (7.6%) of cancer development. It is caused by use of areca nut in various forms. Areca nut contains high level of copper as compared to other commonly eaten nuts. Copper acts as cofactor of lysyl oxidase (LOX) that controls maturation of collagen. Aims: The aim of the study is to estimate tissue copper level in OSMF patients with habit of areca nut chewing and to correlate any change in tissue copper level with histopathological grading of OSMF. Materials and Methods: A hospital based case-control study was done on 30 subjects visiting out-patient department (OPD) of Kothiwal Dental College Moradabad, of which 15 were clinically diagnosed OSMF cases with habit of areca nut chewing and 15 were taken as controls with no habit of areca nut chewing. Tissue copper levels were measured by Atomic Absorption Spectrophotometer (AAS). Results : The study showed highly significant difference in mean tissue copper level (P < 0.001) in patients with OSMF and controls, with patients exhibiting higher tissue copper level (6.43 ± 1.11) in contrast to control who presented low tissue copper level (4.35 ± 0.91), also a highly significant correlation (P < 0.001) was seen between increase in tissue copper level and histopathological staging of OSMF. Conclusions : The present study confirms the hypothesis that copper level in increased in areca nut chewers presenting OSMF. Moreover, copper level increased with increased in histopathological grade of OSMF.