Salivary growth factors differ in type 2 diabetes after tooth extraction

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Frontiers in Medicine Published April 22, 2026 Medically reviewed April 25, 2026 Study authors: Mohammed Amjed Alsaegh, Yousuf Ibrahim Al Shehhi, Shishir Ram Shetty, Sam Thomas Kuriadom, Okba Mahm… DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Consider that salivary growth factor responses to tooth extraction may differ in controlled type 2 diabetes, but evidence is preliminary.

This was a prospective observational comparative study with 27 participants: 20 with controlled type 2 diabetes and 7 healthy controls. The intervention was tooth extraction, with healthy controls as the comparator. The primary outcome was salivary growth factor levels (EGF, TGF-α, FGF, PDGF-AB, PDGF-CC, PDGF-DD) before and two days after extraction.

For EGF, there were no significant differences between groups at baseline (p=0.333) or post-extraction (p=0.571). TGF-α levels were not significantly different at baseline (p=0.088) or two days post-extraction (p=0.915). FGF levels showed no significant differences at baseline (p=0.064) or post-extraction (p=0.677). PDGF-DD, PDGF-CC, and PDGF-AB levels decreased in both groups between baseline and the second post-extraction day, except for a slight increase in PDGF-AB in controls; no significant differences between groups were found at baseline or two days post-extraction.

Safety and tolerability were not reported. Key limitations include a small sample size, short follow-up period, and an observational design that cannot establish causality. Practice relevance suggests salivary growth factors are reduced and respond differently in type 2 diabetes, potentially impairing oral wound healing, but supplementation requires further investigation. Findings should be interpreted with caution due to the small cohort and short follow-up.

Study Details

Study typeCohort

EvidenceLevel 3

PublishedApr 2026

View Original Abstract ↓

This study aimed to evaluate salivary growth factor levels in controlled type 2 diabetic patients compared to healthy individuals, assessed at two time points: before tooth extraction and two days postoperatively. The study included 27 participants: 20 with type 2 diabetes (74.07%) and 7 healthy controls (25.93%). Unstimulated whole saliva samples were collected before tooth extraction and two days afterward. Biomarker analysis was performed using a Luminex multiplex assay, targeting epidermal growth factor (EGF), transforming growth factor-alpha (TGF-α), fibroblast growth factor (FGF), platelet-derived growth factor-AB (PDGF-AB), platelet-derived growth factor-CC (PDGF-CC), and platelet-derived growth factor-DD (PDGF-DD). EGF levels showed no significant differences between groups at baseline (p = 0.333) or post-extraction (p = 0.571); however, two days after extraction, EGF levels almost remained steady in diabetics but decreased in controls. TGF-α was not significantly different between diabetics and control groups at baseline and two days post-extraction (p = 0.088; p = 0.915, respectively), with levels increasing in diabetics and decreasing in controls two days after extraction. FGF levels showed no significant differences at baseline (p = 0.064) or post-extraction (p = 0.677), from baseline to second post-extraction day, the levels were increasing in diabetics and decreasing in controls. Between baseline and the second day post-extraction, the levels of PDGF-DD, PDGF-CC, and PDGF-AB decreased in both groups, except for PDGF-AB in the control group, where a slight increase was observed. No significant differences were found between the diabetic and control groups for PDGF-DD, PDGF-CC, or PDGF-AB at baseline (p = 0.810, p = 0.382, p = 0.881) or two days post-extraction (p = 0.860, p = 0.414, p = 0.740), respectively. Salivary growth factors are reduced and respond differently in type 2 diabetes, potentially contributing to impaired oral wound healing. Supplementing growth factors may improve clinical outcomes, warranting further investigation.