Salivary Proteins as Dental Caries Biomarkers: A Systematic Review

Abstract

Salivary proteins play an important role in repairing mechanisms of damaged tissues and the maintenance of oral health. However, there is a dearth of information in the literature regarding the concentrations of salivary proteins in caries-free (CF) and caries-active (CA) subjects. Hence, this systematic review was conducted to update our previous systematic review published in 2013 that aimed to assess the association between caries and salivary proteins by comparing CF and CA individuals. Thereby, evaluating the possibility of whether salivary proteins can be regarded as biomarkers for caries. An extensive search of studies was conducted using PubMed, EMBASE, Clarivate Analytics’ Web of Science, and Elsevier’s Scopus between July 2012 and January 2022, without any language restriction. Manual searching in Google Scholar and evaluation of bibliographies of the included studies were also undertaken. The Newcastle-Ottawa Scale was used to assess the risk of bias (RoB) within the included studies. Of 22 included studies, 1,551 human subjects (range: 30–213 participants) were recruited, of which 848 individuals (54.7%) were CA and 703 (45.3%) were CF. Regarding the utilization of DMFT as the caries index, high variability was observed across different articles. A statistically significant increase in the salivary levels of alpha-amylase, acidic proline-rich protein-1, histatin-5, lactoperoxidase, and mucin-1 was found in CA patients, while the salivary levels of carbonic anhydrase 6, proteinase-3, and statherin were observed to be significantly increased in CF subjects. Conflicting results were found regarding the salivary levels of immunoglobulin A and total proteins among CA and CF subjects. The included studies were categorized as low RoB (<i>n</i> = 15), medium RoB (<i>n</i> = 4), and high RoB (<i>n</i> = 3). Due to significant heterogeneity among the included studies, no meta-analysis could be performed. In conclusion, the salivary levels of protein(s) might be a useful biomarker for caries diagnosis, especially alpha-amylase, acidic proline-rich protein-1, histatin-5, lactoperoxidase, mucin-1, carbonic anhydrase 6, proteinase-3, and statherin. However, their diagnostic value must be verified by large-scale prospective studies.

Role of salivary proteins on radiation-related caries onset in head and neck cancer patients treated with radiotherapy - a longitudinal study.

“…Regarding RC presence at 12 months, both groups showed signi cant differences in salivary protein concentration assessed at 6 months. The ndings are consistent with previous studies that have shown that salivary protein variation in patients is associated with increased risk of caries [46,47] . However, there are few studies that have emphasised the differences in salivary composition between individuals with and without RC.…”

Emerging polymeric materials for treatment of oral diseases: design strategy towards a unique oral environment

“…Notably, alterations in the concentration of several molecules presented in saliva have proven valuable in diagnosing and monitoring oral diseases, including dental caries, periodontitis, oral squamous cell carcinoma, and Sjo ¨gren's syndrome. 46,47 The interaction between saliva and polymeric materials used in oral rehabilitation or tissue regeneration is inherent, which may lead to chemical-physical-biological changes in polymeric materials, such as hydrophilicity, degradation, morphology, surface properties, and biocompatibility. 48,49 The acidic conditions can lead to phase/morphology change and even degradation of polymeric materials that are sensitive to pH.…”

“…Notably, alterations in the concentration of several molecules presented in saliva have proven valuable in diagnosing and monitoring oral diseases, including dental caries, periodontitis, oral squamous cell carcinoma, and Sjögren's syndrome. 46,47…”

Host–Guest Mechanism via Induced Fit Fullerene Complexation in Porphin Receptor to Probe Salivary Alpha-Amylase in Dental Caries for Clinical Applications

“…Lately, scientists are studying the potential of saliva as an alternative, noninvasive biofluid for the diagnosis of several pathological conditions by the evaluation of biomarkers and monitoring the therapeutic outcomes. , Being the first fluid facing exogenous substances, the composition and quality of saliva play a major role in caries development. It is considered an essential host factor in the colonization of bacteria and progression of caries. , Various antimicrobial salivary proteins and enzymes play a prominent role in maintaining the overall oral health . By the establishment of a range for the normal values of salivary and exogenous components, the oral health status of an individual can be monitored.…”

“…3,14 Various antimicrobial salivary proteins and enzymes play a prominent role in maintaining the overall oral health. 15 By the establishment of a range for the normal values of salivary and exogenous components, the oral health status of an individual can be monitored. Among the several other specific enzymes and electrolytes, salivary α-amylase is the most abundant enzyme found in human saliva.…”