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O potencial dos biomarcadores salivares no diagnóstico precoce de patologias orais: revisão integrativa
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Introdução: A saliva é um fluido biológico que reflete o estado de saúde oral e sistémico de um indivíduo. A recolha é um processo simples e rápido, que constitui uma alternativa eficaz e minimamente invasiva à tradicional análise sanguínea. Através dos testes salivares é possível detetar biomarcadores como enzimas, proteínas, hormonas, e categorizar o microbioma oral, permitindo a identificação precoce de várias patologias. A abordagem conhecida como “Salivómica”, devido à sua capacidade de analisar em profundidade as moléculas presentes na saliva, melhora sensivelmente as capacidades diagnósticas, possibilitando uma análise profunda das moléculas salivares.
Objetivo: Realizar uma revisão integrativa da literatura demonstrativa da utilidade do uso da saliva como 1) teste diagnóstico para identificação precoce da cárie dentária, da doença periodontal e da Síndrome de Sjögren, 2) como instrumento para elaboração de um tratamento personalizado e preciso destas patologias orais 3) como instrumento de monitorização da progressão da doença e da resposta ao tratamento.
Metodologia: Pretendeu-se responder à seguinte questão: “Existe atualmente evidência científica suficiente que fundamente a aplicabilidade dos testes salivares no diagnóstico precoce e monitorização das cáries dentárias, doença periodontal e síndrome de Sjögren, em comparação aos métodos diagnósticos convencionais considerando a sua sensibilidade e especificidade?”. Foi realizada uma pesquisa bibliográfica nas bases de dados online PubMed, Wiley e ScienceDirect. A identificação e seleção dos artigos foram conduzidas utilizando critérios de inclusão e de exclusão previamente elaborados. São incluídos artigos com texto completo publicados entre o 2014 e o 2025, em inglês, italiano e português, que relatam estudos em humanos e que respondem à questão PICO. São excluídos os artigos sem uma versão completa publicados em idiomas diferentes dos indicados, fora do período temporal definido para a seleção e artigos não relacionados com o objetivo da revisão integrativa.
Resultados: Os estudos analisados demonstraram que os biomarcadores salivares, como a albumina, os componentes do microbioma e eletrólitos salivares, apresentam uma associação significativa com a presença e gravidade da cárie dentária. Nas doenças periodontais, os biomarcadores salivares revelaram capacidade preditiva elevada para distinguir entre o estado de saúde, gengivite e periodontite. No caso da síndrome de Sjögren, o proteoma salivar demonstrou uma elevada sensibilidade diagnóstica.
Conclusão: Os testes salivares mostram-se promissores no diagnóstico precoce de patologias orais, mas exigem validação adicional e padronização para aplicação clínica segura e eficaz.
Introduction: Saliva is a biological fluid that reflects an individual's oral and systemic health status. Its collection is a simple and quick process, constituting an effective and minimally invasive alternative to traditional blood sampling. Through salivary tests, it is possible to detect biomarkers such as enzymes, proteins, hormones, and to categorize the oral microbiome, allowing for the early identification of various pathologies. The approach known as “Salivaomics,” due to its ability to deeply analyse the molecules present in saliva, significantly enhances diagnostic capabilities, enabling an in-depth analysis of salivary molecules. Objective: To carry out an integrative literature review demonstrating the usefulness of saliva as: 1) a diagnostic test for early identification of dental caries, periodontal disease, and Sjögren’s syndrome; 2) a tool for developing personalized and precise treatment for oral pathologies; 3) an instrument for monitoring disease progression and treatment response. Methodology: This study aimed to answer the following question: “Is there currently sufficient scientific evidence to support the applicability of salivary tests in the early diagnosis and monitorization of dental caries, periodontal disease, and Sjögren’s syndrome, in comparison to conventional diagnostic methods, considering their sensitivity and specificity?” A bibliographic search was conducted in the online databases PubMed, Wiley, and ScienceDirect. Article identification and selection were conducted using previously established inclusion and exclusion criteria. Included were full-text articles published between 2014 and 2025, in English, Italian, and Portuguese, reporting studies in humans and addressing the PICO question. Excluded were articles without a full-text version, published in languages other than those specified, outside the defined time frame, or not related to the objective of the integrative review. Results: The analyzed studies demonstrated that salivary biomarkers, such as albumin, microbiome components, and salivary electrolytes, show a significant association with the presence and severity of dental caries. In periodontal diseases, salivary biomarkers revealed a high predictive capacity to distinguish between health, gingivitis, and periodontitis. In the case of Sjögren’s syndrome, the salivary proteome showed high diagnostic sensitivity. Conclusion: Salivary tests prove to be promising in the early diagnosis of oral pathologies but require further validation and standardization for safe and effective clinical application.
Introduction: Saliva is a biological fluid that reflects an individual's oral and systemic health status. Its collection is a simple and quick process, constituting an effective and minimally invasive alternative to traditional blood sampling. Through salivary tests, it is possible to detect biomarkers such as enzymes, proteins, hormones, and to categorize the oral microbiome, allowing for the early identification of various pathologies. The approach known as “Salivaomics,” due to its ability to deeply analyse the molecules present in saliva, significantly enhances diagnostic capabilities, enabling an in-depth analysis of salivary molecules. Objective: To carry out an integrative literature review demonstrating the usefulness of saliva as: 1) a diagnostic test for early identification of dental caries, periodontal disease, and Sjögren’s syndrome; 2) a tool for developing personalized and precise treatment for oral pathologies; 3) an instrument for monitoring disease progression and treatment response. Methodology: This study aimed to answer the following question: “Is there currently sufficient scientific evidence to support the applicability of salivary tests in the early diagnosis and monitorization of dental caries, periodontal disease, and Sjögren’s syndrome, in comparison to conventional diagnostic methods, considering their sensitivity and specificity?” A bibliographic search was conducted in the online databases PubMed, Wiley, and ScienceDirect. Article identification and selection were conducted using previously established inclusion and exclusion criteria. Included were full-text articles published between 2014 and 2025, in English, Italian, and Portuguese, reporting studies in humans and addressing the PICO question. Excluded were articles without a full-text version, published in languages other than those specified, outside the defined time frame, or not related to the objective of the integrative review. Results: The analyzed studies demonstrated that salivary biomarkers, such as albumin, microbiome components, and salivary electrolytes, show a significant association with the presence and severity of dental caries. In periodontal diseases, salivary biomarkers revealed a high predictive capacity to distinguish between health, gingivitis, and periodontitis. In the case of Sjögren’s syndrome, the salivary proteome showed high diagnostic sensitivity. Conclusion: Salivary tests prove to be promising in the early diagnosis of oral pathologies but require further validation and standardization for safe and effective clinical application.
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Palavras-chave
Teste salivar Diagnóstico precoce Biomarcadores salivares Não invasividade Proteómica salivar Salivaómica Salivary test Early diagnosis Salivary biomarkers Non-invasiveness Salivary proteomics Salivaomics