Table 1 Detailed protocol from therapies used for salivary stimulation of salivary glands to management of hyposalivation caused by systemic diseases or conditions. For the characteristics and main results of each study, see Appendix Table 3
Author, country, year, type of study | Condition causing hyposalivation | Physical method used for salivary glands stimulation | Protocol (number of sections in bold) |
|---|---|---|---|
Aggarwal et al. India 2015 SACT [30] | Healthy subjects without hyposalivation | TENS | Electrodes bilaterally on the skin overlying the parotid gland region Frequency 100 Hz and pulse duration 100-150 µs After a 2-min break, the TENS unit was activated and the amplitude was increased to a maximum tolerated level for 5 min Single application |
Amaral et al. Brazil 2012 RCT [31] | Chemothrapy-induced | TENS | G1 = Pulse frequency of 50 Hz and pulse duration of 250 microseconds 3 sessions weekly for 30 min each Electrodes in the 3 regions of the face that corresponded to the major salivary glands G2 = TENS + Hyperboloid; G3 = Without salivary stimulation; G4 = Balanced masticatory exercises after meals using a hyperboloid (mechanical sialogogue), for 10 min, 4 × a day Patients underwent therapy from day 7 before hematopoietic stem cell transplantation (D-7) to day 30 after transplantation (D30) |
Bhasin et al. India 2015 SACT [32] | Healthy subjects without hyposalivation | TENS | Electrodes bilaterally on the skin overlying the parotid gland region The device used operates with a frequency of 0.1 to 500 Hz. Amplitude was increased to a maximum tolerable level for the patient for 5 min Single application |
Blom et al. Switzerland 1992 RCT [19] | SS, Medication-induced, unknown cause, hypothyroidism, heart disease, hypertension, rheumatic diseases, postmenopausa | Acupuncture | G1 = 6 to 8 local and distal points and 2 to 4 auricular points, with insertions at depths between 0.5 and 2.0 cm and approximately 1 to 3 mm into the ear G2 = intraoperative needles dermal (superficial acupuncture) G1 and G2 = 2x/week, 20 min, for 6 weeks. Interval of 7 to 10 days and protocol repetition for another 6 weeks |
Brzak et al. Croatia 2017 RCT [33] | Medication-induced | Laser | G1 = Power of 35mW and wavelength of 830 nm. 5.2 Hz pulse repetition rate G2 = Power of 30mW and wavelength of 685 nm. 5.2 Hz pulse repetition rate Approximately 14.4 J per session in G1 and G2 6 irradiation points. Each application with different duration depending on the gland and laser wavelength The treatment lasted 10 consecutive days for G1 and G2 |
Cafaro et al. Italy 2014 RCT [34] | SS | Laser acupuncture | G1 = Light in the red visible spectrum (650 nm), power of 5 mW, 120 s per acupuncture point, total dose of 0.6 J 1x/week for 5 weeks (5 sessions)6 acupuncture points stimulated bilaterally G2 = G1 protocol, but without emitting radiation |
Chandra et al. India 2022 NRCT [35] | Diabetes, chemothrapy-induced, smokers, healthy subjects without hyposalivation | TENS | Electrodes bilaterally on the skin overlying the parotid gland region Frequency between 20–50 Hz, intensity according to the patient's tolerance 2x/week every 15 days, for 1 month (4 times in total) |
Medication-induced | Laser | G1 = Wavelength of 830 nm, power of 35 mW, frequency of 5.2 Hz, alternating mode (on: 800 ms, off: 1 ms) and dose of 1.60 J/cm2 Extraoral and intraoral irradiation points (does not inform quantity) Each session lasted 20 min, 10 min per side of the face (total of 120 s of irradiation per session) The laser was repeated every day, except on weekends, for 14 days (10 sessions) G2 = Same protocol, but with the device turned off | |
Medication-induced | Acupuncture | G1 = 5 acupuncture points on both ears for 30 min Participants received press needles in one ear to be used until the second session (1 week later). The remaining three sessions were every seven days (5 sessions) G2 = Water in a spray bottle (0.5 L) was given to participants to use ad libitum for 2 weeks. The patients did not know that it was pure water | |
Dawidson et al. Sweden 1997 SACT [37] | Healthy subjects without hyposalivation | Acupuncture and electroacupuncture | Acupuncture at 6 points bilaterally The same patients received low-frequency electrical stimulation (2 Hz) evoked with a Multiple Electronic Acupuntoscope. The needles at points St6 and Li4 were connected to the electropulse bilaterally, and the electrical current was adjusted between 2–4 mA. Electrical stimulation was applied for 20 min Single application |
Dyasnoor et al. India 2017 SACT [21] | Diabetes | TENS | Electrodes bilaterally on the skin overlying the parotid gland region Pulse rate fixed at 50 Hz and intensity according to patient tolerance Single application |
Fidelix et al. Brazil 2018 RCT [38] | SS | Laser | G1 = Wavelength 808 nm, 100 mW, and in continuous wave mode 2x/week for 6 weeks (12 sessions) 12 extraoral irradiation points and 2 intraoral irradiation points 4 J per stitch for 40 s. Total energy dose per session: 56 J G2 = G1 protocol, but without emitting radiation |
Hargitai et al. United States of America 2005 SACT [39] | Healthy subjects without hyposalivation | TENS | Electrodes bilaterally on the skin overlying the parotid gland region The pulse rate was fixed at 50 Hz, the pulse duration was fixed at 250 ms and the unit was in normal mode. Reach the maximum intensity tolerable by the patient. Application for 5 min Single application |
Konidena et al. India 2016 NRCT [40] | Postmenopausa | TENS | Electrodes bilaterally on the skin overlying the parotid gland region 50 Hz frequency, 220 V, 0–100 mA at 1 k load, biphasic waveform, available in pulsed/continuous form and in 2 intensities The TENS unit was activated in continuous mode, with maximum intensity tolerated by the patient for 15 min (40 patients supported intensity II); Single application |
Nimma et al. India 2012 SACT [41] | Healthy subjects without hyposalivation | TENS | Electrodes bilaterally on the skin overlying the parotid gland region The pulse rate was fixed at 50 Hz and the amplitude was the maximum tolerated by the patient. Application for 5 min Method applied on 2 consecutive days |
Pandey et al. India 2019 SACT [42] | Healthy subjects without hyposalivation | TENS | Day 1: Citric acid stimulation for all subjects. Rinse with 5 mL of citric acid solution (25%) for 15 s 2nd day: Stimulation with TENS for all individuals. Electrodes bilaterally on the skin overlying the parotid gland region. The pulse rate was fixed at 50 Hz and the amplitude was the maximum tolerated by the patient. Application for 5 min |
Pattipati et al. India 2013 SACT [43] | Healthy subjects without hyposalivation | TENS | Electrodes bilaterally on the skin overlying the parotid gland region 50 Hz pulse rate, unit in normal mode Single application. No information regarding TENS application time |
Ramesh et al. India 2021 SACT [44] | Healthy subjects without hyposalivation | TENS | Electrodes bilaterally on the skin overlying the parotid gland region The pulse rate was fixed at 50 Hz and the amplitude was the maximum tolerated by the patient. Application for 5 min Single application |
Shetawy et al. Egypt 2021 SACT [45] | Diabetes | Laser | 905 nm wavelength, 100mW power, 2 J energy per point and 28 J dose per session 2x/week for 6 weeks (total of 12 sessions) 14 points of extraoral irradiation The application time was 30 s per point (total duration of 420 s) |
Simões et al. Brazil 2009 CR [46] | SS | Laser | G1 = Wavelength of 780 nm, power of 15mW, in continuous wave mode, dose of 3.8 J/cm2 For 8 months, treatment was given 3x/week for 4 weeks, followed by a 1-week break, and then treatment was resumed 10 s per point. 30 extraoral irradiation points and 6 intraoral points |
Singh et al. India 2015 SACT [47] | Healthy subjects without hyposalivation | TENS | Electrodes bilaterally on the skin overlying the parotid gland region The amplitude was the maximum tolerated by the patient. Application for 5 min. Rate and pulse were not reported Single application |
Smriti et al. India 2014 SACT [23] | Medication-induced, postmenopausa, diabetes | TENS | Electrodes bilaterally on the skin overlying the parotid gland region Pulse rate of 50 Hz, duration of 250 microseconds, unit in normal mode up to the maximum intensity tolerated by the patient Single application |
Vilas et al. India 2009 SACT [48] | Healthy subjects without hyposalivation | TENS | Electrodes bilaterally on the skin overlying the parotid gland region The pulse rate was fixed at 50 Hz and the amplitude was the maximum tolerated by the patient. Application for 5 min Single application |
Yang et al. China 2022 NRCT [49] | Hemodialysis | TENS on acupuncture points | G1 = Frequency of 50 Hz and a pulse duration of 250 μs. Electrodes were placed on 2 acupuncture points bilaterally and the stimulation lasted for 20 min G2 = Same treatment as G1, but with a frequency of 2 Hz and a pulse of 50 μs |