Incorporation of antimicrobials in artificial saliva

• Ano de defesa: 2025
• Autor(a) principal: Carneiro, Camila Alves
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: eng
• Instituição de defesa: Biblioteca Digitais de Teses e Dissertações da USP
• Palavras-chave em Português: Artificial saliva; Candida albicans; Nanoparticles; Nanopartículas de prata; Revisão sistemática; Saliva artificial; Systematic review; Xerostomia
• Link de acesso: https://www.teses.usp.br/teses/disponiveis/25/25146/tde-12062025-112704/

Artificial saliva is critical in maintaining oral functions such as mastication, speech, and overall oral homeostasis for patients suffering from xerostomia and hyposalivation. These conditions are linked to an increased risk of oral pathologies, such as denture stomatitis, often caused by microbial biofilms, especially Candida albicans. Recent advancements have sought to enhance the properties of artificial saliva through the incorporation of novel agents, including plant-based mucilage, proteins, and nanoparticles. A systematic review was conducted to evaluate the physical and antimicrobial properties of these new artificial saliva formulations compared to conventional ones. A total of 15 studies, including clinical, in vitro, and in vivo research, were selected, covering 377 patients with evaluation periods ranging from 1 to 60 days. These studies demonstrated improvements in viscosity, retention time, pH, and antimicrobial efficacy. Concurrently, experimental research assessed the fungistatic and fungicidal effects of artificial saliva formulations containing nystatin (Nyst), chlorhexidine diacetate 98% (Chx), and varying concentrations of silver nanoparticles (AgNp) (2mM, 4mM, and 6mM) on C. albicans biofilm by determination their MIC and MFC. 35 heat-polymerized acrylic resin specimens were created as experimental substrates, with five specimens per group (AS, AS+AgNp2mM, AS+AgNp4mM, AS+AgNp6mM, AS+Nyst, AS+Chx) plus the control group. Biofilms were developed on the treated and untreated surfaces for 3, 6, and 12 hours and quantified using colony-forming units per milliliter (CFU/mL). Statistical analysis (p<0.05) confirmed significant inhibition of biofilm formation for AS+Nist, AS+Chx, and AS+Ag6mM. These results suggest that new artificial saliva formulations incorporating antimicrobial agents offer significant improvements in both physical properties and biofilm inhibition. Given their enhanced therapeutic potential, these formulations may be a viable alternative for managing xerostomia, hyposalivation, and associated conditions like denture stomatitis. However, further research is required to validate their long-term efficacy, safety, and patient satisfaction .