Impact of modifications on the characteristics of salivary pellicle on dental hard tissue: a scoping review

Abstract

Objectives The salivary pellicle regulates interfacial events on dental surfaces and is a promising target for modification to improve dental health. This scoping review systematically examines substances that modify the pellicle, evaluating their potential and identifying knowledge gaps. Data This review followed the PRISMA-ScR guidelines. Studies investigating how substances applied during pellicle formation on enamel or dentin affect its structure, composition, or protective function were included. Sources A systematic search of Medline was conducted up to March 2024 using predefined terms. Only English-language research articles were included. No hand-searching was performed. Study selection A total of 864 records were identified. After title and abstract screening, 110 articles were assessed in full, resulting in 85 eligible studies for data charting. These studies investigated human saliva-derived pellicles on enamel or dentin, comparing their composition, structure, or protective properties with and without modification. Most studies, conducted equally in vitro and in situ, focused on fluorides and metals (n = 28), peptides and proteins (n = 21), and polyphenols (n = 18), while other substances were less frequently examined (n = 17). Modifications affected the pellicle’s ultrastructure, altered its proteome, or enhanced its protective role against erosion, abrasion, and bacterial adherence. Conclusions Despite numerous studies and distinct substance classes, findings remain inconclusive and must be interpreted within the context of individual study designs. Clinical significance Modifying the pellicle can improve its protective function, presenting a promising approach for preventive dentistry. However, the long-term effects of these substances within the dynamic oral environment remain unclear. This review underscores the need for further research to close existing knowledge gaps and confirm clinical relevance.