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Published on: December 26, 2016
Salivary Parameters Before and After Removable Complete Denture Rehabilitation: A Systematic Review and Meta-Analysis
Cátia Sufia Alves Freire de Andrade1, Mariana Alves Dos Santos1, Mirtes Maria Ferreira Corrêa1
1Department of Prosthodontics and Periodontology, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.
Background:
Salivary parameters are clinically relevant for complete denture (CD) lubrication, comfort, retention, and adaptation in edentulous patients. Although an immediate salivary response following CD insertion is biologically plausible, the magnitude and persistence of changes in salivary flow, pH, and biomarkers after treatment remain incompletely understood.
Objective:
To investigate whether the installation of new CDs influences salivary parameters (flow rate, pH and biomarkers) in edentulous patients, both under stimulated and unstimulated conditions.
Methods:
Five databases were searched to identify clinical studies comparing total salivary flow, salivary pH and biomarkers before and after CD installation. The ROBINS-I tool was used to assess risk of bias, and Comprehensive Meta-Analysis software (version 3.2) was used to perform the meta-analysis; biomarker data were synthesized descriptively.
Results:
Twenty-two studies were selected, comprising 645 edentulous patients rehabilitated with CDs, evaluated immediately after CD installation and at 2-3 months. Eight were included in the quantitative analysis. Six studies had a serious risk of bias, and 16 had a critical risk. The meta-analyses showed significant increases in both stimulated and unstimulated salivary flow, as well as in salivary pH, immediately after CD insertion and after 2-3 months of use (p < 0.05). Descriptive analysis revealed time-dependent changes in salivary biomarkers for inflammation, oxidative stress and immunity following CD installation.
Conclusion:
CD installation increased salivary flow, both stimulated and unstimulated, and salivary pH over time, with biological changes reflected by salivary biomarkers. However, because of the high risk of bias, these findings should be interpreted with caution.
