OXIDATIVE STRESS AND ANTIOXIDANT MARKERS IN ORAL SUBMUCOUS FIBROSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF CASE-CONTROL STUDIES.

OBJECTIVE: This meta-analysis systematically investigates the markers of oxidative stress (OS) and antioxidant systems in the saliva and serum of patients with oral submucous fibrosis (OSF) and healthy controls. METHODS: Using a comprehensive search of databases from their inception period to December 31, 2023, articles related to OS or antioxidant markers in patients with OSF and healthy controls were retrieved. Literature screening and data extraction were performed by two reviewers according to the set criteria, and a third evaluator was involved in case of disagreements. The included studies were assessed with the Newcastle-Ottawa Scale, and the results were analyzed using Review Manager 5.4 software. RESULTS: A total of 14 studies were included. Patients with OSF exhibited significantly higher levels of malondialdehyde (serum: SMD: 7.65, 95% confidence interval [CI]: 5.14-10.17, P < .00001, saliva: SMD: 3.07, 95% CI: 0.6-5.54, P < .00001) and 8-hydroxy-deoxyguanosine (saliva: SMD: 4.84, 95% CI: 3.49-6.18, P < .00001) than healthy controls. Levels of vitamin C (serum: SMD: -3.54, 95% CI: -4.10 to -2.99, P < .00001, saliva: SMD: -1.10, 95% CI: -1.39 to -0.80, P < .00001), vitamin E (saliva: SMD: -1.78, 95% CI: -2.1 to -1.45, P < .00001), and superoxide dismutase (serum: SMD: -9.77, 95% CI: -13.79 to -5.74, P < .00001) were significantly lower in patients with OSF than in healthy controls. CONCLUSIONS: The results showed increased levels of OS markers and decreased levels of antioxidant markers in patients with OSF, providing valuable indicators that may aid in clinical diagnosis and management.