Modulation of the acquired enamel pellicle by hemoglobin: a scoping review

This scoping review investigates the potential of Hemoglobin in pellicle engineering, particularly regarding protection against erosion and bacterial adherence.

Studies investigating the effects of Hemoglobin on pellicles formed by human saliva on enamel or dentin were included.

A literature search was conducted in Medline and Web of Science up to February 2026. Only English-language research articles were considered. Hand-searching, including checking reference lists, was not conducted.

A total of 3.225 records were identified. After removing duplicates, the titles, abstracts and full texts were screened, resulting in 8 included studies. All studies were conducted on enamel pellicles (n = 8). Hemoglobin demonstrated enamel-binding ability and modified the pellicle proteome by increasing acid-resistant proteins, enhancing resistance to erosion. Only one study evaluated the effects on bacterial adhesion and caries prevention. Combinations with sodium trimetaphosphate showed synergistic effects, though overall findings were mixed.

Hemoglobin has emerged as a potential agent for altering the acquired pellicle to enhance protection against erosion. Nevertheless, the current evidence remains limited, highlighting the need for additional studies conducted under conditions that better reflect clinical reality.

Modification of the pellicle with Hemoglobin may improve its protective properties.