Salivary secretory immunoglobulin A and its association with dental caries in children and adolescents: A systematic review and meta-analysis

Objective: to perform systematic search and both quantitative and qualitative synthesis of published evidence on the associations between salivary secretory immunoglobulin A (IgA) and caries in children and adolescents. Review methodology. A systematic review with meta-analysis based on papers published in journals indexed in PubMed and eLibrary indexing systems. The search for papers was not limited in time and language of publications, methods of determining IgA. The results reflected in dissertations, reports, clinical cases and recommendations were not included. Random effects meta-analysis was performed with Cohen’s d as a measure of the effect. Higgins – Thompson I2 was used as a measure of heterogeneity. All results are presented with 95% confidence interval. In total, 140 original articles were identified using our search criteria. After screening and using exclusion criteria, the final sample for qualitative synthesis consisted of 15 publications. Of them, 11 publications have reported greater values of secretory IgA levels in oral fluid in children and adolescents without caries was noted, in 8 of them a statistically significant difference was revealed. Weighted average effect was 0.76 (95% confidence interval –0,22–1,74) with high degree of heterogeneity (I2=96,5%). Conclusion. Although the majority of original articles provide the evidence on the association between salivary secretory IgA and dental caries, the results of meta-analysis do not reach the level of statistical significance suggesting that the evidence is inconclusive and warranting further research on the associations between salivary secretory IgA and dental caries.