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Díaz-Fabregat B, Ramírez-Carmona W, Cannon ML, Monteiro DR, Pessan JP, Antoniali C. Are salivary NO 2- / NO 2- and NO 3- levels biomarkers for dental caries in children? Systematic review and meta-analysis. Nitric Oxide 2024; 144:11-19. [PMID: 38185241 DOI: 10.1016/j.niox.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 11/15/2023] [Accepted: 01/05/2024] [Indexed: 01/09/2024]
Abstract
The literature is conflicting regarding salivary nitrite (NO2-)/nitrite and nitrate (NO2- and NO3-) levels in children affected by dental caries. For this reason, a systematic review to provide a consensus on the subject was propose, whose objective is to verify whether these molecules could be used as biomarkers in children with caries. A comprehensive search was performed on online database and eleven articles were included in the meta-analysis. The methodological quality of studies was assessed by Newcastle-Ottawa Scale recommended for case-control studies and by AXIS tool for cross-sectional studies. Grading of Recommendations Assessment, Development and Evaluation was used for the assessment of the certainty of the evidence for each outcome. The results showed lower NO2- levels in the group of children affected by dental caries (SMD = -2.18 [-3.24, -1.13], p < 0.01). Age, saliva collection and methods of evaluation can impact the results. When evaluating the severity of the condition, an important variation was detected in relation to the different evaluation methods NO2-/NO2- and NO3-. In conclusion, based on the evidence presented, the results suggest that NO2- levels in saliva are a possible biomarker of dental caries. Results should be evaluated with caution due to the very low evidence from primary studies. Longitudinal studies are necessary to strengthen this hypothesis.
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Affiliation(s)
- Beatriz Díaz-Fabregat
- São Paulo State University (UNESP), Araçatuba School of Dentistry, Department of Preventive and Restorative Dentistry, Rua José Bonifácio 1193 Araçatuba, SP, Zip code 16015-050, Brazil
| | - Wilmer Ramírez-Carmona
- São Paulo State University (UNESP), Araçatuba School of Dentistry, Department of Preventive and Restorative Dentistry, Rua José Bonifácio 1193 Araçatuba, SP, Zip code 16015-050, Brazil
| | - Mark Lloyd Cannon
- Feinberg School of Medicine, Northwestern University, Ann and Robert Lurie Childrens Hospital, 420 E Superior St, Chicago, IL, 60611, USA
| | - Douglas Roberto Monteiro
- São Paulo State University (UNESP), Araçatuba School of Dentistry, Department of Preventive and Restorative Dentistry, Rua José Bonifácio 1193 Araçatuba, SP, Zip code 16015-050, Brazil; University of Western São Paulo (UNOESTE), Postgraduate Program in Health Sciences, Rua José Bongiovani 700 Presidente Prudente, SP, Zip code 19050-920, Brazil
| | - Juliano Pelim Pessan
- São Paulo State University (UNESP), Araçatuba School of Dentistry, Department of Preventive and Restorative Dentistry, Rua José Bonifácio 1193 Araçatuba, SP, Zip code 16015-050, Brazil
| | - Cristina Antoniali
- São Paulo State University (UNESP), Araçatuba School of Dentistry, Department of Basic Science, Rua José Bonifácio 1193 Araçatuba, SP, Zip code 16015-050, Brazil.
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