Relationship between salivary biomarkers and postoperative swelling after the extraction of impacted lower third molars

Int J Oral Maxillofac Surg. 2017 Feb;46(2):243-249. doi: 10.1016/j.ijom.2016.10.005. Epub 2016 Nov 3.


Many authors have studied various different parameters in relation to postoperative anxiety after the extraction of third molars. However, the effect that the acute inflammatory process occurring post extraction could have on these parameters has not been studied. Certain salivary biomarkers, although not specifically inflammatory, may be affected by the acute inflammatory process occurring following the extraction of a retained lower third molar. Three biomarkers were assessed in this study: total protein, immunoglobulin A (IgA), and alpha-amylase. A total of 15 patients were recruited. Four samples of saliva were taken from each patient: before extraction, immediately after extraction, at 2h after extraction, and at 7 days after extraction. The concentrations of the proteins in the saliva were measured. The average values of each marker were compared across the different stages of the study. Statistical analysis revealed that of the three salivary biomarkers, only alpha-amylase was associated with an inflammatory response to the surgery (P<0.05). These results suggest the possibility that salivary alpha-amylase levels may be affected by the acute inflammation occurring post extraction; therefore, this would not be an appropriate marker to use in the study of other situations, unless this interference is controlled for.

Keywords: alpha-amylase; immunoglobulin A; oral swelling; third molar surgery; total proteins.

MeSH terms

  • Adult
  • Amylases / analysis
  • Biomarkers / analysis*
  • Edema / etiology*
  • Female
  • Humans
  • Immunoglobulin A / analysis
  • Male
  • Molar, Third / surgery*
  • Postoperative Complications / etiology*
  • Saliva / chemistry*
  • Salivary Proteins and Peptides / analysis
  • Tooth Extraction*
  • Tooth, Impacted / surgery*


  • Biomarkers
  • Immunoglobulin A
  • Salivary Proteins and Peptides
  • Amylases