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Erschienen in: Clinical Dentistry Reviewed 1/2018

Open Access 01.11.2018 | Treatment

Artificial salivas

verfasst von: Guy Carpenter

Erschienen in: Periodontal and Implant Research | Ausgabe 1/2018

Quick reference/description

Mucosa is hydrated by the continuous flow of watery saliva over the mucosa and by the adhesion of mucins. This helps in keeping the mucosa moist and lubricated.
Artificial salivas mimic the viscous nature of saliva but lack the other physical properties of saliva [1, 2]. To supplement any pre-existing saliva, artificial salivas should be complementary to any pre-existing saliva when used with dry mouth patients. Saliva has a lower surface tension than water which is created by the presence of surface active proteins. The low surface tension aids in spreading a thin film over the mucosa [3], but the low surface tension in artificial salivas, due to the presence of certain chemicals, overwhelms the natural surface tension of saliva which speeds evaporation.

Indications

Xerostomia or dry mouth, swallowing problems, taste disturbances or ulcerated mucosa.

Materials/instruments

Whole mouth saliva collectors, dry mouth visual analogue scales, Bother Index, Challacombe scale of clinical effects of xerostomia, rheometers were used.

Procedure

Assessment of dry mouth should include subjective and objective symptoms. Salivary flow rate should be calculated (by measuring the volume over a set time), subjective signs by the Bother index or short questionnaire and objective symptoms by the Challacombe scale [4].

Composition of artificial salivas

To create viscosity, the main polymer in artificial salivas is either carboxymethylcellulose or xanthan gum. Low surface tension of artificial saliva is created by the addition of volatiles such as menthol. They also contain bioactives that are components extracted from natural sources (animals or plants) that have some of the bacteriostatic or antibacterial effects of natural saliva (Table 1).
Table 1
Composition of artificial salivas; all compositions were disclosed as per the manufacturer’s website and/or SDS (safety data sheet)
Trade name
Bulk polymer
Actives
Preservatives
Others
BioXtra™
Hydroxyethylcellulose
Lactoferrin, lactoperoxidase lysozyme
Potassium thiocyanate
Aloe barbadensis
Saliveze™
Carboxymethylcellulose
Calcium chloride
Methylparaben
 
GC Dry Mouth Gel™
Cellulose gum/carrageenan
 
Ethylparaben
 
Saliva Orthana™
Pig gastric mucin
Potassium fluoride
Benzoate
Ethylenediaminetetraacetic acid (EDTA)
Biotene™
Xanthan gum/glycerine
Cetylpyridinium chloride
Benzoate, methylparaben
 
Glandosane™
Sodium carboxymethylcellulose
Calcium chloride
Sodium chloride
 

Physical properties of artificial and natural salivas

Physical properties of saliva include:
  • Viscosity
  • Elasticity
  • Surface tension
  • Surface and bulk viscoelasticity

Other possible sources for artificial saliva

The other sources for artificial saliva currently being researched include:
  • Post-transplantation of bio-engineered whole or mini-glands produced by laboratory biofabrication processes [5]
  • Customized laboratory-based artificial saliva [6]
  • Customized mouth splints designed to create a reservoir for longer delivery.

Pitfalls and complications

  • Artificial salivas lack effectiveness.
  • They do not mimic the elastic component and the pellicle-forming properties of real saliva.
  • They have very low surface tension that destroys the properties of any existing saliva.
  • Lack of suitable in vivo models to test artificial salivas
Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Literatur
2.
Zurück zum Zitat Furness S, Worthington HV, Bryan G, Birchenough S, McMillan R (2011) Interventions for the management of drymouth: topical therapies. Cochrane Database Syst Rev 12:106 Furness S, Worthington HV, Bryan G, Birchenough S, McMillan R (2011) Interventions for the management of drymouth: topical therapies. Cochrane Database Syst Rev 12:106
3.
Zurück zum Zitat Klein J (2012) Polymers in living systems: from biological lubrication to tissue engineering and biomedical devices. Polym Adv Technol 23(4):729–735CrossRef Klein J (2012) Polymers in living systems: from biological lubrication to tissue engineering and biomedical devices. Polym Adv Technol 23(4):729–735CrossRef
4.
Zurück zum Zitat Osailan S, Pramanik R, Shirodaria S, Challacombe SJ, Proctor GB (2011) Investigating the relationship between hyposalvation and mucosal wetness. Oral Dis 17(1):109–114CrossRefPubMed Osailan S, Pramanik R, Shirodaria S, Challacombe SJ, Proctor GB (2011) Investigating the relationship between hyposalvation and mucosal wetness. Oral Dis 17(1):109–114CrossRefPubMed
5.
Zurück zum Zitat Lomaert I, Movahednia MM, Adine C, Ferreira JN (2017) Concise review: salivary gland regeneration: therapeutic approaches from stem cells to tissue organoids. Stem cells 35(1):97–105CrossRef Lomaert I, Movahednia MM, Adine C, Ferreira JN (2017) Concise review: salivary gland regeneration: therapeutic approaches from stem cells to tissue organoids. Stem cells 35(1):97–105CrossRef
6.
Zurück zum Zitat Veeregowda DH, Kolbe A, van der Mei HC, Busscher HJ, Herrmann A, Sharma PK (2013) Recombinant superchargedpolypeptides restore and improve biolubrication. Adv Mater 25(25):3426–3431CrossRefPubMed Veeregowda DH, Kolbe A, van der Mei HC, Busscher HJ, Herrmann A, Sharma PK (2013) Recombinant superchargedpolypeptides restore and improve biolubrication. Adv Mater 25(25):3426–3431CrossRefPubMed
Metadaten
Titel
Artificial salivas
verfasst von
Guy Carpenter
Publikationsdatum
01.11.2018
Verlag
Springer International Publishing
Erschienen in
Periodontal and Implant Research / Ausgabe 1/2018
Elektronische ISSN: 2948-2453
DOI
https://doi.org/10.1007/s41894-018-0033-5

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