Assessment of proteomic salivary biomarkers for diagnosis of early childhood caries: a systematic review

Background: Severe early childhood caries (s-ECC) remains a highly prevalent condition among children worldwide, posing a considerable burden in both developed and developing regions. This systematic review seeks to comprehensively identify, synthesize, and critically evaluate available evidence on salivary proteomic and peptidomic biomarkers that may aid in the diagnosis or risk assessment of ECC. Aim and objectives: This study aims to evaluate any difference in the level of proteomic salivary biomarkers in children with and without ECC. Methods: A comprehensive search was conducted across four major electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via PubMed, Scopus, and Google Scholar. From an initial yield of 1,253 records, 11 studies fulfilled the eligibility criteria and were included for data extraction. The risk of bias for the included studies was assessed using the QUADAS-2 tool for the Quality Assessment of Diagnostic Accuracy Studies. Results: Of the 11 studies included, quality appraisal using the QUADAS-2 indicated that 3 out of 11 studies had low risk in all domains, while the remaining studies had unclear or high-risk domains. Conclusion: The pooled evidence suggests that salivary biomarkers have significant potential for detecting ECC. Utilizing salivary diagnostics may enhance the prevention of new carious lesions. Future clinical trials with robust methodologies are recommended to generate further conclusive evidence. Clinical significance: Salivary proteomic biomarkers, including MS protein, mucins, amylase, glycoproteins, proline, and glycine, may provide additional value in the early diagnosis of ECC in pediatric populations. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023468566, PROSPERO CRD42023468566.