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Guney Z, Altingoz SM, Has H, Serdar MA, Kurgan S. The impact of electronic cigarettes on peri-implant health: A systematic review and meta-analysis. J Dent 2024; 143:104883. [PMID: 38360396 DOI: 10.1016/j.jdent.2024.104883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVES Recent literature suggests that the use of electronic cigarette (e-cigarette) is a substantial contributing factor to the unsuccessful outcomes of dental implant procedures. Our aim was to systematically review the effect of e-cigarette use on clinical (PI, PD, BOP), radiographic (bone loss), and immunologic (IL-1β) peri‑implant parameters. DATA Main search terms used in combination: electronic cigarette, peri‑implantitis, vaping. SOURCES An electronic search was undertaken for MEDLINE, EMBASE, COCHRANE, and SCOPUS databases between 2017 and 2023. STUDY SELECTION The study protocol was developed according to PRISMA guidelines, and the focus question was formulated according to the PICO strategy. No restriction was accepted regarding language or year to avoid selection bias; the initial database search yielded 49 publications. Following the selection process, only seven studies met the inclusion criteria. Seven studies were statistically analyzed via MedCalc program. A pooled effect was deemed statistically significant if the p-value was less than 0.05. CONCLUSION Electronic cigarettes cause an increase in probing depth, bone loss, and the level of IL-1β, one of the bone destruction mediators in the tissues around the implant, and a decrease in bleeding on probing. CLINICAL SIGNIFICANCE E-cigarette is a potential risk factor for the healing process and the results of implant treatment, similar to cigarettes. Performing clinical research to evaluate the e-cigarette effect on peri‑implantitis in an age and gender-match population is needed.
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Affiliation(s)
- Zeliha Guney
- Department of Periodontology, Faculty of Dentistry, Ankara Medipol University, Ankara, Turkey
| | - S Merve Altingoz
- Department of Periodontology, Faculty of Dentistry, Lokman Hekim University, Ankara, Turkey
| | - Hande Has
- Graduate School of Health Sciences, Ankara University, Ankara, Turkey
| | - Muhittin A Serdar
- Department of Medical Biochemistry, School of Medicine, Acibadem University, İstanbul, Turkey
| | - Sivge Kurgan
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey.
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Charde P, Ali K, Hamdan N. Effects of e-cigarette smoking on periodontal health: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002311. [PMID: 38507403 PMCID: PMC10954179 DOI: 10.1371/journal.pgph.0002311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 02/22/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVES Use of electronic cigarettes (ECs), also known as vaping, has gained remarkable popularity globally during the last decade especially among young people. Current evidence suggests that vaping may be associated with health risks. The aim of this study is to evaluate whether vaping increases the risk for initiation and progression of periodontal disease; and to appraise the clinical changes seen in patients using e-cigarettes, and how these changes impact the management of periodontal disease. STUDY SELECTION, DATA AND SOURCES A comprehensive electronic search was conducted on the PubMed, Scopus and Embase databases using the following search terms: Electronic Cigarettes OR vaping OR electronic nicotine delivery systems OR e-cigarettes AND Periodontitis. The search was limited to studies published from 1st January 2012 to 31st December 2022. RESULTS A total of 23 clinical studies focusing on the effect of e-cigarette smoking on the periodontal clinical parameters, levels of inflammatory mediators, alteration in periodontal microflora, and response to periodontal treatment were found to be eligible for inclusion in the review. Vaping may be associated with greater clinical attachment loss (CAL) compared to non-smokers. Moreover, ECs are also associated with unfavorable effects on periodontal microbial counts, biomarkers of inflammation and oxidative stress. CONCLUSIONS Vaping may play a role in the initiation and progression of periodontal disease by altering the host response resulting in the release of inflammatory cytokines and periodontal microflora. Clinical studies show deleterious effects of vaping on periodontal health as well as less favourable response to periodontal treatment is observed in e-cigarette users compared to non-smokers. However, compared to cigarette smoking, the effects of vaping are less remarkable.
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Affiliation(s)
- Priti Charde
- Qatar University, QU Health, College of Dental Medicine, Doha, Qatar
| | - Kamran Ali
- Qatar University, QU Health, College of Dental Medicine, Doha, Qatar
| | - Nader Hamdan
- Qatar University, QU Health, College of Dental Medicine, Doha, Qatar
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Thiem DGE, Donkiewicz P, Rejaey R, Wiesmann-Imilowski N, Deschner J, Al-Nawas B, Kämmerer PW. The impact of electronic and conventional cigarettes on periodontal health-a systematic review and meta-analysis. Clin Oral Investig 2023; 27:4911-4928. [PMID: 37526741 PMCID: PMC10492702 DOI: 10.1007/s00784-023-05162-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/13/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVES This systematic review and meta-analysis examined the effects of electronic cigarettes on periodontal health compared to conventional cigarette smoke and a non-smoking population. MATERIALS AND METHODS MEDLINE, Embase, Web of Science, CENTRAL, and ClinicalTrials.gov were screened for literature. Eligibility criteria included clinical studies published between 2006 and 2022 that compare e-cigarettes and conventional cigarettes on periodontal health (bleeding on probing (BoP), plaque index (PI), probing depth (PD), attachment loss (AL), marginal bone loss (MBL), tooth loss, molecular inflammation markers, salivary flow rate). Meta-regression analysis was used to examine the influence of moderator variables. RESULTS Sixteen studies were found to be eligible for qualitative synthesis. Individual analyses showed that cigarette smokers had significantly higher PI, PD, AL, and MBL and increased concentrations of proinflammatory mediators than e-cigarette users and non-smokers. Meta-analysis revealed a 0.33-fold lower chance for BoP in e-cigarette users compared to smokers (p = 0.03), whereby meta-regression failed to detect any effects regarding the age of users and frequency of smoking. A 0.01-fold decreased chance for positive BoP in e-cigarette users compared with non-smokers was seen (p < 0.01). CONCLUSIONS The current findings suggest that that e-cigarette use might be considered a healthier alternative to cigarette smoking concerning periodontal health. Even so, harmful effects of electronic nicotine delivery system (ENDS) usage on periodontal health were seen as well. However, a definitive decision on this research question remains elusive due to the absence of randomized controlled trials. CLINICAL RELEVANCE Electronic cigarettes, marketed as a safer alternative to traditional cigarettes, are becoming increasingly popular. Evidence on the use of electronic cigarettes as a cessation aid and its beneficial impact compared to cigarette smoke remains inconclusive, so the analysis conducted in this review addresses a recent question of high clinical relevance.
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Affiliation(s)
- Daniel G. E. Thiem
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Phil Donkiewicz
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
- Department of Periodontology and Operative Dentistry, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
- BioHorizons Camlog, Maybachstr. 5, 71299 Wimsheim, Germany
| | - Raha Rejaey
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Nadine Wiesmann-Imilowski
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Peer W. Kämmerer
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
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Al-Kheraif AA, Alshahrani OA, Al-Shehri AM, Khan AA. Antimicrobial photodynamic therapy using chloro-aluminum phthalocyanine for treating advanced stage-III periodontitis in smoking patients. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2022; 38:591-599. [PMID: 35811336 DOI: 10.1111/phpp.12816] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/29/2022] [Accepted: 07/05/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE To evaluate the bacterial, clinical, and cytokine profile of adjunctive photodynamic therapy using chloro-aluminum phthalocyanine (CAP/aPDT) with root surface debridement (RSD) versus RSD alone in cigarette smokers (CS) and never-smokers (NS) during the period of 6 months. METHODS Twenty-nine patients [CS - 14 and NS - 15] were recruited for the trial having stage-III periodontitis. All candidates from the study groups were subjected to a split-mouth treatment technique receiving CAP/aPDT + RSD and RSD alone. Periodontal parameters including plaque levels (PL), bleeding on probing (BP), probing depth (PD), clinical attachment loss (CAL), and marginal bone loss (MBL) were assessed. Polymerase chain reaction (qPCR) assay was used to analyze the copy numbers of Porphyromonas gingivalis (Pg) and Tannerella forsythia (Tf). Levels of tumor necrosis factor-alpha (TNF-α) interleukin (IL)-6 in the crevicular fluid were evaluated by enzyme-linked immunosorbent assay (ELISA). RESULTS CAP/aPDT+RSD decreased BP in smokers after 6 months (p < .05). Probing depth and CAL reported statistically significant reductions within both CAP/aPDT+RSD and RSD groups and also within the NS and CS (p < .05). Pg and Tf stayed elevated in smokers at the 6-month evaluation period (p < .01). Only CAP/aPDT+RSD significantly decreased Pg and Tf at 3- and 6-month follow-up in smokers (p < .05). CAP/aPDT+RSD showed decreased IL-6 levels in the NS during the 6-month follow-up (p < .01). TNF-α levels were significantly reduced in the CS group with CAP/aPDT+RSD and RSD alone until 6 months (p < .01). CONCLUSION CAP-mediated aPDT along with nonsurgical periodontal therapy helped to improve the bacteriological outcomes among smokers and never-smokers with stage-III CP patients.
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Affiliation(s)
- Abdulaziz A Al-Kheraif
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Obaid Abdullah Alshahrani
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah M Al-Shehri
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Aftab Ahmed Khan
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Al-Kheraif AA, Alshahrani OA, Al-Shehri AM, Khan AA. Chloro-aluminum phthalocyanine-mediated photodynamic therapy in the treatment of stage-II chronic periodontitis among smokers. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2022; 38:582-590. [PMID: 35678189 DOI: 10.1111/phpp.12811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/08/2022] [Accepted: 06/06/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE To assess the clinical periodontal, bacterial, and immunological outcomes of chloro-aluminum phthalocyanine-mediated photodynamic therapy (PDT) as an adjunct to dental scaling (DS) versus DS alone among cigarette smokers (CS) and never-smokers (NS). METHODS A total of 26 patients (13 CS and 13 NS) with clinical and radiographic diagnosis of stage-II chronic periodontitis were recruited. Each patient from both groups were subjected with two parallel therapies (split-mouth): PDT + DS (test side) and DS alone (control side). Periodontal parameters were investigated by evaluating plaque scores (PS), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), and alveolar bone loss (ABL). Subgingival plaque was collected to detect and quantify Porphyromonas gingivalis and Tannerella forsythia using real-time quantitative polymerase chain reaction (RT-qPCR) assay. Gingival crevicular fluid was sampled for the quantification of interleukin (IL)-1β and tumor necrosis factor-alpha (TNF-α) using enzyme linked immunosorbent assay. All assessments were performed at baseline, 3 months, and 6 months. RESULTS Bleeding on probing was significantly reduced at 6 months after PDT + DS in CS groups (p < .05). Mean PD and CAL significantly reduced after both PDT + DS and DS subgroups and among NS and CS groups (p < .05). At 6 months follow-up, the copy number of both P. gingivalis and T. forsythia remained significantly high in CS group (p < .01). Only PDT + DS subgroup in CS significantly reduced the counts of P. gingivalis and T. forsythia at 3 months and 6 months (p < .05). Only at 6 months did PDT + DS showed statistically significantly reduced IL-1β levels in the NS group (p < .01). TNF-α levels significantly reduced in CS group with PDT + DS and DS alone at both 3 months and 6 months follow-up (p < .01). CONCLUSION Chloro-aluminum phthalocyanine-mediated PDT helped to improve the non-surgical periodontal therapy outcomes among stage-II chronic periodontitis patients among smokers and never-smokers.
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Affiliation(s)
- Abdulaziz A Al-Kheraif
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Obaid Abdullah Alshahrani
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah M Al-Shehri
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Aftab Ahmed Khan
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Farronato D, Azzi L, Giboli L, Maurino V, Tartaglia GM, Farronato M. Impact of Smoking Habit on Peri-Implant Indicators following Different Therapies: A Systematic Review. Bioengineering (Basel) 2022; 9:bioengineering9100569. [PMID: 36290537 PMCID: PMC9598905 DOI: 10.3390/bioengineering9100569] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/05/2022] [Accepted: 10/08/2022] [Indexed: 11/16/2022] Open
Abstract
Peri-implant disease and its treatment is becoming a major concern for clinicians as the number of implants placed each year is rising. Smoking is a common habit, and it is associated with an increased risk of developing peri-implant disease. The role of smoking in the response to peri-implant treatment has never been investigated. Searches were conducted in electronic databases to screen articles published until August 2021. The included studies had at least two groups of patients: peri-implant disease only or peri-implant disease and smoking status. Outcomes of interest included plaque index (PI), probing depth (PD), bleeding on probing (BoP), radiographic crestal bone loss (CBL), and analysis of peri-implant sulcular fluid. Seven hundred and forty-nine articles were found in the databases, only 71 articles potentially qualified. A total of seven studies with a minimum follow-up of six months were included. There is no homogeneity in the diagnosis, smoker definition and treatment proposed. All surgical and non-surgical treatment have statistically significantly different outcomes in smokers and nonsmokers. Recognizing this study’s limitations, we conclude that smoking might play a significant role on the outcome of peri-implant disease treatment. None of the proposed treatments appear to be significantly more effective.
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Affiliation(s)
- Davide Farronato
- Department of Medicine and Surgery, School of Dentistry, University of Insubria, 21100 Varese, Italy
| | - Lorenzo Azzi
- Department of Medicine and Surgery, School of Dentistry, University of Insubria, 21100 Varese, Italy
| | - Luca Giboli
- Department of Medicine and Surgery, School of Dentistry, University of Insubria, 21100 Varese, Italy
- Correspondence:
| | - Vittorio Maurino
- Department of Medicine and Surgery, School of Dentistry, University of Insubria, 21100 Varese, Italy
| | - Gianluca Martino Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy
- UOC Maxillo-Facial Surgery and Dentistry Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Department of Orthodontics, School of Dentistry, University of Milan, 20122 Milan, Italy
| | - Marco Farronato
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy
- UOC Maxillo-Facial Surgery and Dentistry Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Department of Orthodontics, School of Dentistry, University of Milan, 20122 Milan, Italy
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Wasfi RA, Bang F, de Groh M, Champagne A, Han A, Lang JJ, McFaull SR, Melvin A, Pipe AL, Saxena S, Thompson W, Warner E, Prince SA. Chronic health effects associated with electronic cigarette use: A systematic review. Front Public Health 2022; 10:959622. [PMID: 36276349 PMCID: PMC9584749 DOI: 10.3389/fpubh.2022.959622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/29/2022] [Indexed: 01/24/2023] Open
Abstract
Introduction Over the last decade, e-cigarette use has been on the rise but with growing health concerns. The objective of this systematic review was to update findings for chronic health outcomes associated with e-cigarette use from the 2018 National Academies of Sciences, Engineering, and Medicine (NASEM) report. Methods Three bibliographic databases were searched to identify studies comparing the chronic health effects of e-cigarette users (ECU) to non-smokers (NS), smokers, and/or dual users indexed between 31 August 2017 and 29 January 2021. Two independent reviewers screened abstracts and full texts. Data were extracted by one reviewer and verified by a second one. Outcomes were synthesized in a narrative manner using counts and based on statistical significance and direction of the association stratified by study design and exposure type. Risk of bias and certainty of evidence was assessed. The protocol was prospectively registered on Open Science Framework https://osf.io/u9btp. Results A total of 180 articles were eligible. This review focused on 93 studies for the 11 most frequently reported outcomes and from which 59 reported on daily e-cigarette use. The certainty of evidence for all outcomes was very low because of study design (84% cross-sectional) and exposure type (27% reported on exclusive ECU, i.e., never smoked traditional cigarettes). Overall, the summary of results for nearly all outcomes, including inflammation, immune response, periodontal and peri-implant clinical parameters, lung function, respiratory symptoms, and cardiovascular disease, suggested either non-significant or mixed results when daily ECU was compared to NS. This was also observed when comparing exclusive ECU to NS. The only notable exception was related to oral health where most (11/14) studies reported significantly higher inflammation among daily ECU vs. NS. Compared to the smokers, the exclusive-ECUs had no statistically significant differences in inflammation orperiodontal clinical parameters but had mixed findings for peri-implant clinical parameters. Conclusions This review provides an update to the 2018 NASEM report on chronic health effects of e-cigarette use. While the number of studies has grown, the certainty of evidence remains very low largely because of cross-sectional designs and lack of reporting on exclusive e-cigarette exposure. There remains a need for higher quality intervention and prospective studies to assess causality, with a focus on exclusive e-cigarette use.
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Affiliation(s)
- Rania A. Wasfi
- Applied Research Division, Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, ON, Canada,*Correspondence: Rania A. Wasfi
| | - Felix Bang
- Surveillance and Epidemiology Division, Centre for Immunization and Respiratory Infectious Diseases, Infectious Diseases Programs Branch, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Margaret de Groh
- Applied Research Division, Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Andre Champagne
- Behaviours, Environments and Lifespan Division, Centre for Surveillance and Applied Research, Health Promotions and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Arum Han
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Justin J. Lang
- Applied Research Division, Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, ON, Canada,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Steven R. McFaull
- Behaviours, Environments and Lifespan Division, Centre for Surveillance and Applied Research, Health Promotions and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Alexandria Melvin
- Centre for Indigenous Statistics and Partnerships, Statistics Canada, Ottawa, ON, Canada
| | - Andrew Lawrence Pipe
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada,Division of Cardiac Prevention & Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Shika Saxena
- Behaviours, Environments and Lifespan Division, Centre for Surveillance and Applied Research, Health Promotions and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Wendy Thompson
- Behaviours, Environments and Lifespan Division, Centre for Surveillance and Applied Research, Health Promotions and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Emily Warner
- Vaccine Safety, Vaccine Surveillance, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Stephanie A. Prince
- Applied Research Division, Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, ON, Canada,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada,Stephanie A. Prince
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Alhumaidan AA, Al-Aali KA, Vohra F, Javed F, Abduljabbar T. Comparison of Whole Salivary Cortisol and Interleukin 1-Beta Levels in Light Cigarette-Smokers and Users of Electronic Nicotine Delivery Systems before and after Non-Surgical Periodontal Therapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11290. [PMID: 36141565 PMCID: PMC9517181 DOI: 10.3390/ijerph191811290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/20/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
There are no studies that have compared whole salivary cortisol (CL) and interleukin 1-beta (IL-1β) levels in cigarette-smokers (CS) and electronic nicotine delivery systems (ENDS)-users before and after non-surgical periodontal therapy (NSPT). The aim was to compare whole salivary CL and IL-1β levels in light CS and ENDS users before and after non-surgical periodontal therapy (NSPT). Self-reported current CS, ENDS users, and non-smokers were included. A questionnaire was used to collect demographic data. All patients underwent NSPT. Periodontal parameters (probing depth (PD], gingival index (GI], clinical attachment loss (AL], plaque index (PI], and marginal bone loss (MBL]) and whole salivary CL and IL-1β were measured at baseline. At 3-months of follow-up, clinical parameters and whole salivary CL and IL-1β were re-assessed. p-values < 1% were arbitrated as statistically significant. Fifty-four individuals (18 CS, 18 ENDS users, and 18 non-smokers) were included. Clinical AL, MT, PD, PI, and MBL were similar in all groups at baseline. At 12-weeks of follow-up, PI (p < 0.01) and PD (p < 0.01) were high in CS and ENDS-users than non-smokers. Among non-smokers, there was a statistically significant correlation between whole salivary cortisol and IL-1β levels at 12-weeks' follow-up (p < 0.001). There was no difference in whole salivary cortisol and IL-1β levels in CS and ENDS users at baseline and at 12-weeks follow-up. At 12-weeks of follow-up, there was a significant reduction in IL-1β (p < 0.01) and CL (p < 0.01) than baseline. In light CS and ENDS users without periodontal disease, clinical periodontal parameters and whole-salivary CL and Il-1β levels remain unchanged after NSPT.
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Affiliation(s)
- Abdulkareem A. Alhumaidan
- Preventive Dental Sciences Department, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Khulud A. Al-Aali
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
| | - Fahim Vohra
- Prosthetic Dental Sciences Department, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Fawad Javed
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY 14620, USA
| | - Tariq Abduljabbar
- Prosthetic Dental Sciences Department, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
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Pesce P, Menini M, Ugo G, Bagnasco F, Dioguardi M, Troiano G. Evaluation of periodontal indices among non-smokers, tobacco, and e-cigarette smokers: a systematic review and network meta-analysis. Clin Oral Investig 2022; 26:4701-4714. [PMID: 35556173 PMCID: PMC9276554 DOI: 10.1007/s00784-022-04531-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 05/04/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The detrimental effect of tobacco smoking on periodontal health is well known, while the effect of electronic cigarette on periodontal parameters has been less investigated. The aim of the present systematic review was to compare periodontal indices in three categories of patients: traditional cigarette smokers (TS), e-cigarette smokers (ES), and non-smokers (NS). MATERIALS AND METHODS An electronic search was conducted for studies published until December 2021 on MEDLINE (PubMed), ISI Web of Science, and Scopus. A hand search was additionally conducted. Clinical observational and cross-sectional trials investigating periodontal indices among tobacco smokers (TS), electronic cigarette smokers (ES) and non-smokers (NS) were included and selected by 2 independent reviewers. Data on probing depth (PD), plaque index (PI), and bleeding on probing (BOP) were collected. The risk of bias was evaluated according to the NIH quality assessment tool and a network meta-analysis (NMA) was undertaken. RESULTS Five relevant studies, from 707 identified, were included. Overall, 512 patients were included, of them 170 were NS, 176 were TS, and 166 were ES. A significant difference in the comparison among TS vs NS: effect size (ES) = 3.297 (95%CI: [2.142-4.454], p = 0.001) and TS and ES ES = 2.507 (95%CI: [1.351-3.663], p = 0.001) was identified for PD. A significant difference in the comparison among TS and NS, ES = 21.34 (95%CI: [13.41-29.27], p = 0.001) and between TS and ES ES = 15.67 (95%CI: [7.73-23.62], p = 0.001) was identified for PI. The analysis of BOP values shows a significant difference in the comparison among ES and NS: ES = - 16.22 (95%CI: [- 22.85 to - 9.59], p < 0.001) and between TS and NS: ES = - 14.47 (95%CI: [- 21.103 to - 7.848], p < 0.001). Based on the SUCRA ranking, NS showed the most favorable outcome for PD and PI, followed by ES. Tobacco smokers were clearly in the last position. Dealing with BoP ES showed the most favorable outcome, followed by TS. NS were in the last position. CONCLUSIONS Periodontal parameters were similar among NS and ES, while TS presented the worst indices. BoP was reduced both in ES and in TS. CLINICAL RELEVANCE Results of the present review suggest a reduced effect on periodontal tissue of e-cig smoking compared to traditional cigarettes, despite recent studies proved that e-cig smoking increases oxidative stress, inflammatory responses, change in pulmonary cellular behavior, and stimulates DNA injury.
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Affiliation(s)
- Paolo Pesce
- Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy.
| | - Maria Menini
- Division of Prosthodontics, Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
| | - Giovanni Ugo
- Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
| | - Francesco Bagnasco
- Division of Prosthodontics, Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
| | - Mario Dioguardi
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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D’Ambrosio F, Pisano M, Amato A, Iandolo A, Caggiano M, Martina S. Periodontal and Peri-Implant Health Status in Traditional vs. Heat-Not-Burn Tobacco and Electronic Cigarettes Smokers: A Systematic Review. Dent J (Basel) 2022; 10:103. [PMID: 35735645 PMCID: PMC9222105 DOI: 10.3390/dj10060103] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 12/19/2022] Open
Abstract
The aim of the present systematic review was to evaluate and possibly differentiate the effects of traditional cigarettes, heat-not-burn tobacco, and electronic cigarettes on periodontal and peri-implant health status. Electronic cigarettes and heat-not-burn tobacco have become very popular in recent years and have been proposed to consumers as a safer alternative to conventional tobacco smoke, although their effect on periodontal and peri-implant health remains unclear. The study protocol was developed according to PRISMA guidelines, and the focus question was formulated according to the PICO strategy. A literature search was conducted across PubMed/MEDLINE and the COCHRANE library from 2003 to April 2022. From the 1935 titles initially identified, 18 articles were finally included in the study and extracted data were qualitatively synthesized. It may be carefully concluded that e-cigarettes may cause attenuated clinical inflammatory signs of periodontitis and, hypothetically, of peri-implantitis when compared to conventional tobacco smoke. Both alternative smoking products, containing nicotine, may likewise exert negative effects on periodontal and peri-implant health, as demonstrated by in vitro studies. Further investigations are needed to assess the impact of electronic cigarettes and heat-not-burn tobacco products on periodontal and peri-implant health status.
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Affiliation(s)
- Francesco D’Ambrosio
- Department of Medicine, Surgery and Dentistry “Schola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (M.P.); (A.A.); (A.I.); (M.C.); (S.M.)
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Is a single session of antimicrobial photodynamic therapy as an adjuvant to non-surgical scaling and root planing effective in reducing periodontal inflammation and subgingival presence of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans in patients with periodontitis? Photodiagnosis Photodyn Ther 2022; 38:102847. [PMID: 35367618 DOI: 10.1016/j.pdpdt.2022.102847] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The aim was to assess the influence of a single session of antimicrobial photodynamic therapy (aPDT) as an adjunct to non-surgical scaling and root planing (SRP) in reducing periodontal inflammation and subgingival presence of Porphyromonas gingivalis (P. gingivalis) and Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) in patients with periodontitis. METHODS Patients diagnosed with periodontitis were included. Information regarding age and gender was recorded using a questionnaire. All patients underwent full mouth non-surgical SRP and the following parameters were assessed at baseline: (a) marginal bone loss (MBL); (b) probing depth (PD) (c) clinical attachment loss (CAL); and (d) presence of supra-and subgingival bleeding and plaque (GI and PI). Identification of A. actinomycetemcomitans and P. gingivalis was performed using polymerase chain reaction. For aPDT (test-group), methylene-blue (MB) (0.005%) was used as photosensitizer and it was applied over and inside the buccal pockets of teeth. Using a Diode laser at 660 nm and 150 mW, irradiation was performed All clinical parameters except for MBL and microbiological evaluations were re-assessed at 3-months of follow-up. Level of significance was set at P<0.05. RESULTS At 3-months of follow-up A. actinomycetemcomitans and P. gingivalis were identified in significantly lower number of patients in groups 1 and 2 compared with their respective baseline values. Number of patients in whom A. actinomycetemcomitans and P. gingivalis were identified at 3-months of follow-up were similar in both groups. At baseline, there was no statistically significant difference in PI, GI, PD, CAL and MBL among patients in groups 1 and 2. In groups 1 and 2, scores of PI (P<0.001), GI (P<0.001) and PD (P<0.001) were significantly higher at baseline compared with their respective 3-months' follow-up scores. CONCLUSION One application of aPDT with non-surgical SRP is ineffective in managing periodontal inflammation and presence of P. gingivalis and A. actinomycetemcomitans in periodontitis patients.
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Alshibani N, Alssum L, Basudan A, Shaheen M, Alqutub MN, Dahash FA, Alkattan R. Non-surgical periodontal therapy with adjunct photodynamic therapy for the management of periodontal inflammation in adults using nicotine-free electronic-cigarette: A randomized control trial. Photodiagnosis Photodyn Ther 2022; 38:102820. [DOI: 10.1016/j.pdpdt.2022.102820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/11/2022] [Accepted: 03/17/2022] [Indexed: 10/18/2022]
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Alrefaie RM, John J, Alsiwat AJ, Ibraheem WI, Preethanath RS, Divakar DD. Efficacy of antimicrobial photodynamic therapy in reducing oral yeasts carriage among individuals using electronic nicotine delivery systems. Photodiagnosis Photodyn Ther 2022; 37:102724. [PMID: 35051663 DOI: 10.1016/j.pdpdt.2022.102724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/07/2022] [Accepted: 01/14/2022] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The aim was to assess the efficacy of antimicrobial photodynamic therapy (aPDT) in reducing oral yeasts carriage among individuals using electronic nicotine delivery systems (ENDS). METHODS Self-reported ENDS users and non-users (individuals that reported to have never used any nicotinic product) were included. Demographic data was collected using a questionnaire. Patients were divided into 2 subgroups: (a) aPDT group; and (b) sham aPDT group. aPDT was performed using a curcumin-based photosensitizer that was exposed to a central wavelength of 660 nm and an estimated average fluency of 200 J/cm2. The system delivered light by uniform diffusion for 5 minutes. Sham aPDT was performed using a non-activated laser tip. Oral yeasts colony forming units were determined using standard techniques. Oral yeasts were assessed at baseline and at 3-months of follow-up. Level of significance was set at P<0.05. RESULTS Twenty-three ENDS-users (19 males and 4 females) and 23 controls (17 males and 6 females) were included. ENDS-users were vaping for 8.3 ± 0.6 years and were using their ENDS devices 13.6 ± 2.7 times daily. Toothbrushing twice daily was reported by 8.7% and 21.7% of ENDS-users and controls, respectively. Tongue brushing was reported by none of the individuals. At baseline, oral yeasts CFU/ml were significantly higher among ENDS-users in the PDT (P<0.05) and sham PDT (P<0.05) groups compared with controls (Table 2; Figure 1). At 3-months of follow-up, CFU/ml were significantly higher among ENDS-users in the PDT (P<0.05) and sham PDT (P<0.05) groups compared with controls CONCLUSION: : A single session of aPDT is ineffective in reducing the oral yeasts CFU/ml in ENDS-users. Further studies are needed to assess the impact of multiple sessions of aPDT in reducing the oral yeasts CFU/ml in ENDS-users.
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Affiliation(s)
| | - Jacob John
- Department of Dentistry, DM Wayanad Institute of Medical Sciences (DM WIMS), Meppadi, Kerala, India
| | - Areej Jaber Alsiwat
- Dental Health Department, College of Applied Medical Sciences, King Saud University, P.O. Box: 10219, Riyadh, 11433, Saudi Arabia
| | - Wael Ibraheem Ibraheem
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Reghunathan S Preethanath
- Department of Oral Medicine and Radiology, Sharavathi Dental College and Hospital, Shivamogga, Karnataka 577204, India
| | - Darshan Devang Divakar
- Department of Oral Medicine and Radiology, Sharavathi Dental College and Hospital, Shivamogga, Karnataka 577204, India.; Department of Oral Medicine and Radiology, Faculty of Dentistry, Levy Mwanawasa Medical University (LMMU), Ministry of Health, Lusaka 10101, Zambia.
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Early Diagnosis of Oral Mucosal Alterations in Smokers and E-Cigarette Users Based on Micronuclei Count: A Cross-Sectional Study among Dental Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413246. [PMID: 34948855 PMCID: PMC8707162 DOI: 10.3390/ijerph182413246] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 12/29/2022]
Abstract
The presence of micronuclei in oral epithelial cells is considered a marker of genotoxicity, which can be identified using exfoliative cytology. The aim of this study was to investigate cytotoxic damage through the evaluation of micronuclei in the oral mucosa of smokers and e-cigarette users compared to nonsmokers. We obtained smears from the buccal mucosa of 68 participants divided in 3 groups (smokers, e-cigarette users and nonsmokers), which were further processed with Papanicolaou stain. The frequencies of micronuclei and micronucleated cells were recorded and statistically analyzed at a level of significance of p < 0.05. The mean micronuclei values per 1000 cells were 3.6 ± 1.08 for smokers, 3.21 ± 1.12 for e-cigarette users and 1.95 ± 1.05 for nonsmokers. The mean values of micronucleated cells per 1000 cells were 2.48 ± 0.91 for smokers, 2.39 ± 1.07 for e-cigarette users and 1.4 ± 0.68 for nonsmokers. Smokers and e-cigarette users had significantly higher values of micronuclei and micronucleated cells compared to nonsmokers, but there were no significant differences between smokers and e-cigarette users. We concluded that the micronuclei count can be used as an early indicator for alterations of oral mucosa and exfoliative cytology represents an accessible tool which could be applied for mass screening.
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Kanmaz M, Kanmaz B, Buduneli N. Periodontal treatment outcomes in smokers: A narrative review. Tob Induc Dis 2021; 19:77. [PMID: 34707470 PMCID: PMC8494073 DOI: 10.18332/tid/142106] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/19/2021] [Accepted: 09/09/2021] [Indexed: 01/01/2023] Open
Abstract
Smoking is considered as the major environmental risk factor for periodontal diseases. Smokers have a higher risk for severe periodontitis with more periodontal tissue destruction, more gingival recession, and more susceptibility for tooth loss. The aim of this narrative review is to provide up-to-date evidence on the clinical outcomes of periodontal treatment in smokers. Electronic databases were searched for studies that compare the clinical outcomes in smokers and non-smokers following non-surgical and surgical periodontal treatment modalities and also during the supportive periodontal treatment. Clinical studies published before May 2021 were included in the review. Smokers have a higher risk for recurrence of periodontal disease and the response to non-surgical as well as surgical periodontal treatment is not as good as that of non-smokers. Moreover, there is a dose-response effect in the adverse effects of smoking on periodontal health. Compared to non-smokers, smoker patients with periodontitis tend to respond less favorably to non-surgical and surgical periodontal treatment, and exhibit recurrence more frequently during supportive periodontal treatment. Along with the periodontal treatment, smokers may be encouraged to quit. Long follow-up and the communication between the dentist and the patient give a great opportunity for such counseling.
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Affiliation(s)
- Mehmet Kanmaz
- Department of Periodontology, Faculty of Dentistry, Izmir Tınaztepe University, Izmir, Turkey
| | - Burcu Kanmaz
- Department of Periodontology, Faculty of Dentistry, Izmir University of Democracy, Izmir, Turkey
| | - Nurcan Buduneli
- Department of Periodontology, Faculty of Dentistry, Ege University, Izmir, Turkey
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Ibraheem WI, S Preethanath R, Devang Divakar D, Al-Askar M, Al-Kheraif AA. Effect of tongue piercing on periodontal and peri-implant health: A cross-sectional case-control study in adults. Int J Dent Hyg 2021; 20:282-290. [PMID: 33773044 DOI: 10.1111/idh.12499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/03/2021] [Accepted: 03/23/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The authors hypothesize that periodontal and peri-implant inflammatory parameters are poorer in adult patients with tongue piercing compared with controls. The aim was to assess the influence of tongue piercing on periodontal and peri-implant health status in adults. METHODS Test and control groups comprised of individuals with and without tongue piercing, respectively. A questionnaire was used to collect information about gender, age, duration of tongue piercing and implants in function, jaw location of the implant, reasoning for wearing the tongue ornament, and oral hygiene and ornament cleaning habits. Full-mouth and peri-implant plaque index (PI), gingival index (GI), clinical attachment loss (CAL), probing depth (PD) and marginal/crestal bone loss (MBL and CBL, respectively) on mesial and distal surfaces of teeth/implants were recorded. The material (plastic or metal) from which, the bar and ball-ends of the ornament were fabricated was also recorded. A p < 0.01 was considered statistically significant. RESULTS Forty-eight and 49 individuals were included in the test and control groups, respectively. There was no difference in PI, GI, PD, CAL and MBL (mesial and distal) among individuals in the test and control groups. In the test group, peri-implant PI (p < 0.01), GI (p < 0.01), PD (p < 0.01) and mesial (p < 0.01) and distal (p < 0.01) CBL were significantly higher in the anterior mandible compared with implants in other jaw locations. In the control group, there was no difference in peri-implant PI, GI, PD and CBL around implants placed in both jaws. CONCLUSION Wearing tongue piercings could increase the risks of periodontal and peri-implant diseases particularly in the mandibular anterior segment.
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Affiliation(s)
- Wael I Ibraheem
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Reghunathan S Preethanath
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Darshan Devang Divakar
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mansour Al-Askar
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz A Al-Kheraif
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Abstract
Novel nicotine products, particularly electronic cigarettes (e-cigarettes), have become increasingly popular over the past decade. E-cigarettes are sometimes regarded as a less harmful alternative to tobacco smoking, and there is some evidence of their potential role as a smoking cessation aid. However, there are concerns about their health consequences, particularly in users who are not tobacco smokers, and also when used long term. Given the mode of delivery of these products, there is potential for oral health consequences. Over the past few years, there have been an increasing number of studies conducted to explore their oral health effects. In vitro studies have reported a range of cellular effects, but these are much less pronounced than those resulting from exposure to tobacco smoke. Microbiological studies have indicated that e-cigarette users have a distinct microbiome, and there is some indication this may be more pathogenic compared to nonusers. Evidence of oral health effects from clinical trials is still limited, and most studies to date have been small in scale and usually cross-sectional in design. Epidemiological studies highlight concerns over oral dryness, irritation, and gingival diseases. Interpreting data from e-cigarette studies is challenging, given the different populations that have been investigated and the continual emergence of new products. Overall, studies reveal potential oral health harms, underscoring the importance of efforts to reduce use in nonsmokers. However, in smokers who are using e-cigarettes as an aid to help them quit, the benefits of quitting tobacco smoking may outweigh any negative oral health impacts of e-cigarette use, particularly in the short term. Future research is needed to understand the clinical significance of some of the biological changes observed by following different cohorts of users longitudinally in carefully designed clinical studies and pragmatic trials supported by high-quality in vitro studies.
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Affiliation(s)
- R. Holliday
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- R. Holliday, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne NE1 7RU, UK.
| | - B.W. Chaffee
- School of Dentistry, University of California, San Francisco, CA, USA
| | - N.S. Jakubovics
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - R. Kist
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - P.M. Preshaw
- School of Dentistry, University of Dundee, Dundee, UK
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Pouly S, Ng WT, Benzimra M, Soulan A, Blanc N, Zanetti F, Picavet P, Baker G, Haziza C. Effect of Switching to the Tobacco Heating System Versus Continued Cigarette Smoking on Chronic Generalized Periodontitis Treatment Outcome: Protocol for a Randomized Controlled Multicenter Study. JMIR Res Protoc 2021; 10:e15350. [PMID: 33459599 PMCID: PMC7850905 DOI: 10.2196/15350] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 04/30/2020] [Accepted: 12/11/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Smoking is a significant risk factor for periodontal disease and tooth loss, as shown in several clinical studies comparing smokers and nonsmokers. Although only a few longitudinal studies have assessed the outcome of periodontal disease after smoking cessation, they indicated that recovery after nonsurgical treatment was more successful in those who had quit smoking. As part of tobacco harm reduction strategies, substituting cigarettes with alternative, less harmful tobacco products is an approach complementary to cessation for smokers who would otherwise continue to smoke. The Tobacco Heating System (THS), developed by Philip Morris International (commercialized as IQOS), is part of the heat-not-burn product category. The IQOS device electrically heats tobacco instead of burning it, at much lower temperatures than cigarettes, thereby producing substantially lower levels of harmful and potentially harmful constituents, while providing the nicotine, taste, ritual, and a sensory experience that closely parallel those of cigarettes. Phillip Morris International has published the results from a broad clinical assessment program, which was established to scientifically substantiate the harm reduction potential of the THS among adult healthy smokers switching to the THS. The program is now progressing toward including adult smokers with smoking-related diseases. OBJECTIVE The goal of this study is to demonstrate favorable changes of periodontal endpoints in response to mechanical periodontal therapy in patients with generalized chronic periodontitis who completely switched to THS use compared with continued cigarette smoking. METHODS This is a randomized controlled two-arm parallel-group multicenter Japanese study conducted in patients with chronic generalized periodontitis who switch from cigarettes to THS compared with smokers continuing to smoke cigarettes for 6 months. The patients were treated with mechanical periodontal therapy as per standard of care in Japan. The primary objective of the study is to demonstrate the beneficial effect of switching to THS use compared with continued cigarette smoking on pocket depth (PD) reduction in all sites with an initial PD≥4 mm. The secondary objectives include evaluation of other periodontal parameters (eg, clinical attachment level or gingival inflammation) and overall oral health status upon switching to THS. Safety was monitored throughout the study. RESULTS In total, 172 subjects were randomized to the cigarette (n=86) or THS (n=86) groups, and all 172 completed the study. The conduct phase of the study is completed, while data cleaning and analyses are ongoing. CONCLUSIONS This study is the first to test a heat-not-burn tobacco product in smokers with an already established disease. The results should further strengthen the evidence that switching to THS can significantly reduce the risk of smoking-related diseases if favorable changes in the evolution of chronic generalized periodontitis after mechanical therapy are found when compared with continued cigarette smoking. TRIAL REGISTRATION ClinicalTrials.gov NCT03364751; https://clinicaltrials.gov/ct2/show/NCT03364751. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/15350.
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Affiliation(s)
| | - Wee Teck Ng
- Philip Morris Products SA, Neuchâtel, Switzerland
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Figueredo CA, Abdelhay N, Figueredo CM, Catunda R, Gibson MP. The impact of vaping on periodontitis: A systematic review. Clin Exp Dent Res 2020; 7:376-384. [PMID: 33274850 PMCID: PMC8204026 DOI: 10.1002/cre2.360] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 10/21/2020] [Accepted: 10/23/2020] [Indexed: 11/29/2022] Open
Abstract
Background and objective While tobacco cigarette smoking has been proven to be a risk factor for periodontitis, limited information is available regarding vaping, a new alternative to smoking that has been branded as less harmful. Several important in vitro studies have shown that vaping has a similarly damaging effect as cigarette smoking on the health of the periodontium. However, a comprehensive review is lacking in this field. Therefore, we aimed to systematically review the literature about the impact of vaping on periodontitis. Methods The research question was created using the PICOs format. A systematic search of the following electronic databases was performed up to March 2020: Medline, Embase, PubMed, Cochrane, and grey literature. Human studies that assessed periodontal status (plaque index, bleeding on probing, clinical attachment loss, marginal bone loss, and probing depth) in e‐cigarette users compared to non‐smokers (control group) were assessed based on an estimate of fixed effects. The weights of the studies were calculated based on their risks of bias. Results After duplicates were removed, 1,659 studies were screened and 8 case–control studies that investigated the relationship between vaping and periodontal parameters in humans were selected after their risk of bias assessment. Estimated effects of vaping after weighting results based on their standard deviation showed increased plaque, marginal bone loss, clinical attachment loss, pocket depth, and reduced bleeding on probing. Conclusion This study concluded that there is not enough evidence to fully characterize the impacts of vaping on periodontitis. However, within the limitations of our review and the selected included studies, the available results point to increased destruction of the periodontium leading to the development of the disease.
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Affiliation(s)
| | - Nancy Abdelhay
- Faculty of Medicine and DentistryUniversity of AlbertaEdmontonCanada
- Faculty of DentistryAlexandria UniversityEgypt
| | | | - Raisa Catunda
- Faculty of Medicine and DentistryUniversity of AlbertaEdmontonCanada
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Kumar PS. Interventions to prevent periodontal disease in tobacco-, alcohol-, and drug-dependent individuals. Periodontol 2000 2020; 84:84-101. [PMID: 32844411 DOI: 10.1111/prd.12333] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Substance abuse affects more than one sixth of the world's population. More importantly, the nature of the abuse and the type of addictive substances available to individuals is increasing exponentially. All substances with abusive potential impact both the human immuno-inflammatory system and oral microbial communities, and therefore play a critical role in the etiopathogenesis of periodontal diseases. Evidence strongly supports the efficacy of professionally delivered cessation counseling. Dentists, dental therapists, and hygienists are ideally placed to deliver this therapy, and to spearhead efforts to provide behavioral and pharmacologic support for cessation. The purpose of this review is to examine the biologic mechanisms underlying their role in disease causation, to understand the pharmacologic and behavioral basis for their habituation, and to investigate the efficacy of population-based and personalized interventions in prevention of periodontal disease.
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Affiliation(s)
- Purnima S Kumar
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, USA
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Ibraheem WI, Fageeh HI, Preethanath RS, Alzahrani FA, Al-Zawawi AS, Divakar DD, Al-Kheraif AA. Comparison of RANKL and osteoprotegerin levels in the gingival crevicular fluid of young cigarette- and waterpipe-smokers and individuals using electronic nicotine delivery systems. Arch Oral Biol 2020; 115:104714. [DOI: 10.1016/j.archoralbio.2020.104714] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/08/2020] [Accepted: 03/24/2020] [Indexed: 12/19/2022]
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Clinical, host-derived immune biomarkers and microbiological outcomes with adjunctive photochemotherapy compared with local antimicrobial therapy in the treatment of peri-implantitis in cigarette smokers. Photodiagnosis Photodyn Ther 2020; 30:101684. [DOI: 10.1016/j.pdpdt.2020.101684] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/05/2020] [Accepted: 02/07/2020] [Indexed: 12/29/2022]
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Ebersole J, Samburova V, Son Y, Cappelli D, Demopoulos C, Capurro A, Pinto A, Chrzan B, Kingsley K, Howard K, Clark N, Khlystov A. Harmful chemicals emitted from electronic cigarettes and potential deleterious effects in the oral cavity. Tob Induc Dis 2020; 18:41. [PMID: 32435175 PMCID: PMC7233525 DOI: 10.18332/tid/116988] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 11/20/2019] [Accepted: 01/22/2020] [Indexed: 12/29/2022] Open
Abstract
Use of electronic nicotine delivery systems (ENDS), such as electronic cigarettes (e-cigs), is increasing across the US population and is particularly troubling due to their adoption by adolescents, teens, and young adults. The industry’s marketing approach for these instruments of addiction has been to promote them as a safer alternative to tobacco, a behavioral choice supporting smoking cessation, and as the ‘cool’ appearance of vaping with flavored products (e.g. tutti frutti, bubble gum, and buttered popcorn etc.). Thus, there is a clear need to better document the health outcomes of e-cig use in the oral cavity of the addicted chronic user. There appears to be an array of environmental toxins in the vapors, including reactive aldehydes and carbonyls resulting from the heating elements action on fluid components, as well as from the composition of chemical flavoring agents. The chemistry of these systems shows that the released vapors from the e-cigs frequently contain levels of environmental toxins that considerably exceed federal occupational exposure limits. Additionally, the toxicants in the vapors appear to be retained in the host fluids/tissues at levels often approximating 90% of the levels in the e-cig vapors. These water-soluble reactive toxins can challenge the oral cavity constituents, potentially contributing to alterations in the autochthonous microbiome and host cells critical for maintaining oral homeostasis. This review updates the existing chemistry/environmental aspects of e-cigs, as well as providing an overview of the somewhat limited data on potential oral health effects that could occur across the lifetime of daily e-cig users.
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Affiliation(s)
- Jeffrey Ebersole
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, United States
| | - Vera Samburova
- Organic Analytical Laboratory, Division of Atmospheric Sciences, Desert Research Institute, Reno, United States
| | - Yeongkwon Son
- Organic Analytical Laboratory, Division of Atmospheric Sciences, Desert Research Institute, Reno, United States
| | - David Cappelli
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, United States
| | - Christina Demopoulos
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, United States
| | - Antonina Capurro
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, United States
| | - Andres Pinto
- Oral and Maxillofacial Medicine and Diagnostic Sciences, School of Dental Medicine, Case Western University, Cleveland, United States
| | - Brian Chrzan
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, United States
| | - Karl Kingsley
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, United States
| | - Katherine Howard
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, United States
| | - Nathaniel Clark
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, United States
| | - Andrey Khlystov
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, United States
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Kulich RJ, Keith DA, Vasciannie AA, Thomas HF. Interprofessional Collaboration in the Assessment and Management of Substance Use Risk. Dent Clin North Am 2020; 64:571-583. [PMID: 32448460 DOI: 10.1016/j.cden.2020.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Substance use disorder assessment strategies are increasingly being employed by dentistry, while adequate evaluation requires reaching out to other cotreating providers and collaborating on patient care. The field of dentistry has a range of barriers often not experienced in other professions, including limitations on e-record communication and clinical practice setting often isolated from the patient's general medical care. Barriers can be overcome if the dentist facilitates communication.
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Affiliation(s)
- Ronald J Kulich
- Tufts University School of Dental Medicine, Department of Diagnostic Sciences, Craniofacial Pain & Headache Center, 1 Kneeland Street, Boston, MA 02111, USA; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
| | - David A Keith
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, MA, USA
| | - Alexis A Vasciannie
- Department of Diagnostic Sciences, Tufts University School of Dental Medicine, 1 Kneeland Street, Boston, MA 02111, USA
| | - Huw F Thomas
- Tufts University School of Dental Medicine, One Kneeland Street, Room 1163, Boston, MA 02111, USA
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Chaffee B, Urata J, Couch E, Silverstein S. Dental Professionals' Engagement in Tobacco, Electronic Cigarette, and Cannabis Patient Counseling. JDR Clin Trans Res 2020; 5:133-145. [PMID: 31323182 PMCID: PMC7079330 DOI: 10.1177/2380084419861384] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES California features low smoking prevalence, cautionary electronic cigarette (e-cigarette) public messaging, and legal recreational cannabis: a unique landscape for dental professionals to navigate tobacco cessation promotion. This cross-sectional study assessed California dental professionals' self-reported tobacco patient counseling behaviors and the correlates of providing such assistance. METHODS Statewide surveys of dental hygienists (n = 701) and dentists (n = 725) were distributed electronically. The dentist survey was weighted for sampling and nonresponse. Prevalence of asking patients about use was compared for cigarette and noncigarette products (e.g., e-cigarettes, cannabis). Multivariable models identified independent correlates of providing cessation assistance to tobacco-using patients. RESULTS Respondents reported frequently (often/always) documenting patient tobacco use (hygienists: 80%; dentists: 73%) but less commonly provided forms of assistance (hygienists: 27%-49%; dentists: 10%-31%). Most respondents asked patients about cigarette smoking, but noncigarette product use (cigar, hookah, pipe, e-cigarette, or cannabis) was not commonly assessed. Greater confidence and willingness to assist were positively associated with providing assistance in multivariable models, but perceived barriers (e.g., lack of time and remuneration) were not. Results were robust to model specifications. CONCLUSIONS California dental professionals often ask about smoking but lag in providing cessation assistance and inquiring about noncigarette products. Successful efforts to encourage dental professionals' engagement in tobacco prevention and cessation must enhance providers' self-efficacy and motivation and likely will require system and organizational change. KNOWLEDGE TRANSFER STATEMENT Study findings identify substantial gaps in dental professionals' engagement in patient tobacco cessation. The results identify correlates of providing assistance and of dental professionals' willingness and confidence to do so, which could serve to inform interventions to support and enhance engagement.
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Affiliation(s)
- B.W. Chaffee
- Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, CA, USA
| | - J. Urata
- Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, CA, USA
| | - E.T. Couch
- Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, CA, USA
| | - S. Silverstein
- Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, CA, USA
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Alghamdi O, Alrabiah M, Al-Hamoudi N, AlKindi M, Vohra F, Abduljabbar T. Peri-implant soft tissue status and crestal bone loss around immediately-loaded narrow-diameter implants placed in cigarette-smokers: 6-year follow-up results. Clin Implant Dent Relat Res 2020; 22:220-225. [PMID: 32157803 DOI: 10.1111/cid.12893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 02/18/2020] [Accepted: 02/25/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND It is hypothesized that in the long-term, soft tissue inflammation (reflected by increased scores of peri-implant probing-depth [PD]) and crestal bone loss (CBL) is higher in cigarette-smoker than nonsmokers with narrow diameter implants (NDIs). PURPOSE The aim of the present 6-years' follow-up clinical observational study was to compare the peri-implant soft tissue inflammatory parameters (plaque index [PI], gingival index [GI], and PD) and CBL around immediately-loaded NDIs placed in cigarette-smokers and nonsmokers. MATERIALS AND METHODS In all groups, peri-implant GI, PI and PD were measured on six sites (distolingual/palatal, mesiolingual/palatal mesiobuccal, distobuccal, midlingual/palatal, and midbuccal) per implant. The CBL was gauged on digital bitewing x-rays, which were standardized using the long cone paralleling technique. CBL was demarcated as the vertical distance from 2 mm below the implant-abutment connection to the most crestally-positioned alveolar bone. RESULTS All study-participants were male. Twenty-six cigarette smokers and twenty-five nonsmokers were included. The mean age of cigarette-smokers and nonsmokers was 45.5 ± 10.3 and 47.4 ± 9.4 years, respectively. Cigarette-smokers had a smoking history of 10.6 ± 0.4 pack years. Family history of tobacco usage was more often reported by cigarette-smokers (57.7%) than nonsmokers (20%). All cigarette-smokers and nonsmokers were aware that smoking is a risk-factor of loss of implant. Three (11.5%) of cigarette-smokers reported that they have attempted to quit smoking and 76.9% of cigarette-smokers (n = 20) reported that they had no intention to quit smoking in the future. The peri-implant P-I (P < .01), PD (P < .01) and mesial (P < .01), and distal (P < .01) CBL were significantly high in cigarette-smokers compared with nonsmokers. There was no statistically significant difference in GI among the groups. CONCLUSION Cigarette-smoking enhances peri-implant soft tissue inflammation and increases CBL around immediately-loaded NDIs.
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Affiliation(s)
- Osama Alghamdi
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Alrabiah
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nawwaf Al-Hamoudi
- Department of Periodontics and Community Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed AlKindi
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.,Research Chair for Biological Research in Dental Health, College of Dentistry, Riyadh, Saudi Arabia
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.,Research Chair for Biological Research in Dental Health, College of Dentistry, Riyadh, Saudi Arabia
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Alqahtani F, Alqhtani N, Alkhtani F, Devang Divakar D, Al-Kheraif AA, Javed F. Clinicoradiographic markers of peri-implantitis in cigarette-smokers and never-smokers with type 2 diabetes mellitus at 7-years follow-up. J Periodontol 2020; 91:1132-1138. [PMID: 32017116 DOI: 10.1002/jper.19-0501] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/04/2020] [Accepted: 01/14/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND It is hypothesized that in the long-term, (a) peri-implant inflammatory variables (plaque index [PI], bleeding on probing [BOP], probing depth (PD) and crestal bone loss [CBL]) are worse in cigarette-smokers (CS) and patients with type-2 diabetes mellitus (T2DM) than never-smokers (NS) without T2DM. The aim of the present 7-year follow-up clinical observational study was to assess the survival of dental implant in CS and NS with T2DM. METHODS Study participants were divided into four groups based on glycemic status and self-reported cigarette-smoking habit: a) CS with T2DM; b) CS without T2DM; c) NS with T2DM; and d) NS without T2DM. Demographic information was collected using a questionnaire and hemoglobin A1c (HbA1c) levels were measured. Peri-implant PI, BOP, PD, and CBL were measured. Sample-size was estimated was statistical analysis was done using analysis of variance. P <0.01 was considered significant. RESULTS In total, 101 male patients were included. There was no significant contrast in age among the groups. Every partaker in the study groups had one dental implant placed in posterior maxilla or mandible. The mean HbA1c levels were significantly higher among CS (P <0.01) and NS (P <0.01) with T2DM than individuals without T2DM. Peri-implant PI (P <0.01), PD (P <0.01), and CBL (P <0.01) were significantly higher among CS and NS with T2DM and CS without T2DM than NS without T2DM. Peri-implant BOP was significantly higher among CS and NS with T2DM than CS and NS without T2DM (P <0.01). CONCLUSIONS Peri-implant inflammatory variables were worse among CS and NS with T2DM than NS without T2DM. A state of chronic hyperglycemia seems to be a stronger mediator of inflammation than cigarette smoking in patients with T2DM.
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Affiliation(s)
- Fawaz Alqahtani
- Department of Prosthodontics, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Nasser Alqhtani
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Fahad Alkhtani
- Department of Prosthodontics, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Darshan Devang Divakar
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz A Al-Kheraif
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Fawad Javed
- Department of Periodontology, Laboratory for Periodontal-, Implant-, Phototherapy (LA-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.,Division of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
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Yang I, Sandeep S, Rodriguez J. The oral health impact of electronic cigarette use: a systematic review. Crit Rev Toxicol 2020; 50:97-127. [PMID: 32043402 DOI: 10.1080/10408444.2020.1713726] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: Electronic cigarette (e-cigarette) use is becoming more prevalent and is particularly popular among adolescents and conventional smokers. While the oral health sequelae of conventional smoking are well-established, the impact of e-cigarettes on oral health is still unknown. This study aims to systematically review the available research evidence on the oral health impact of e-cigarette use.Methods: This systematic review was conducted according to PRISMA guidelines and used the Effective Public Health Practice Project Quality Assessment Tool to evaluate the evidence. Three electronic databases (PubMed, Web of Science, and Embase) were systematically searched for studies including case reports. Two independent reviewers extracted data and synthesized the findings.Results: Ninety-nine articles were included in this systematic review. Analyses of the articles yielded seven categories based on symptom similarity and/or focus: mouth effects, throat effects, periodontal effects, dental effects, cytotoxic/genotoxic/oncologic effects, oral microbiome effects, and traumatic/accidental injury. The majority of mouth and throat symptoms experienced by e-cigarette users were relatively minor and temporary, with some evidence that conventional smokers who switched to e-cigarettes experienced mitigation of these symptoms. E-cigarette exposure increased the risk for deteriorating periodontal, dental and gingival health as well as changes to the oral microbiome. Extensive dental damage as a result of e-cigarette explosions were described in case reports. Components of e-cigarette vapor have known cytotoxic, genotoxic, and carcinogenic properties.Conclusions: Although switching to e-cigarettes may mitigate oral symptomatology for conventional smokers, findings from this review suggest that a wide range of oral health sequelae may be associated with e-cigarette use. Well-designed studies to investigate oral health outcomes of e-cigarette use are needed.
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Affiliation(s)
- Irene Yang
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Shelly Sandeep
- Emory University Midtown Hospital, Emory University, Atlanta, GA, USA
| | - Jeannie Rodriguez
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
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Holliday R, Chaffee B, Ryan V, McColl E, Preshaw PM. Letter to the editor regarding "Impact of cigarette smoking and vaping on the outcome of full-mouth ultrasonic scaling among patients with gingival inflammation: a prospective study". Clin Oral Investig 2019; 24:517-518. [PMID: 31828521 DOI: 10.1007/s00784-019-03166-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 11/25/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Richard Holliday
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK.
| | - Benjamin Chaffee
- School of Dentistry, University of California San Francisco, San Francisco, CA, USA
| | - Vicky Ryan
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Elaine McColl
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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AlHarthi S, BinShabaib M, Akram Z, Rehman I, Javed F, Romanos G. Letter to the editor replying to Holliday et al. about the article published in clinical oral investigations titled "Impact of cigarette smoking and vaping on the outcome of full-mouth ultrasonic scaling among patients with gingival inflammation: a prospective study". Clin Oral Investig 2019; 24:519-520. [PMID: 31820105 DOI: 10.1007/s00784-019-03167-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 11/25/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Shatha AlHarthi
- Department of Periodontics and Community Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Munera BinShabaib
- Department of Periodontics and Community Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Zohaib Akram
- UWA Dental School, The University of Western Australia, Perth, 6009, Australia.
| | - Irfan Rehman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Fawad Javed
- Laboratory for Periodontal-, Implant-, Phototherapy (LA-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.,Department of Periodontology, Stony Brook University, Stony Brook, NY, USA
| | - Georgios Romanos
- Laboratory for Periodontal-, Implant-, Phototherapy (LA-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.,Department of Periodontology, Stony Brook University, Stony Brook, NY, USA
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31
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Alqahtani F, Alqhtani N, Divakar DD, Shetty SB, Shetty B, Alkhtani F. Self-rated peri-implant oral symptoms and clinicoradiographic characteristics in Narghile-smokers, cigarette-smokers, and nonsmokers with peri-implantitis. Clin Implant Dent Relat Res 2019; 21:1235-1240. [PMID: 31709723 DOI: 10.1111/cid.12864] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 10/16/2019] [Accepted: 10/18/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND The hypothesis is that self-rated peri-implant oral symptoms (OS) and clinical (plaque index [PI] and probing depth [PD]) and radiographic (crestal bone loss [CBL]) are higher in (cigarette-smokers [CS]) and (waterpipe-users) than (nonsmokers [NS]). The aim was to relate peri-implant self-perceived OS with clinico-radiographic parameters among CS, waterpipe-users, and NS. MATERIALS AND METHODS This study was performed on self-reported CS, waterpipe-users, and NS with peri-implantitis. A questionnaire was used to record peri-implant self-perceived OS (pain in gums, bleeding gums, bad breath, and loose implant) and demographic data (age, sex, duration of smoking and waterpipe usage, duration of implants in function, duration since diagnosis of peri-implantitis). Clinico-radiographic parameters (CBL, PD, PI, and bleeding on probing [BOP]) were also measured; and compared with the self-perceived OS. Group comparisons were done for perceived OS and clinico-radiographic variables, and significant differences were deemed when P-values were under .05. RESULTS One hundred male participants (35 CS, 33 waterpipe-users, and 32 NS) with peri-implantitis were included. Pain in gums (P < .05) and bad breath (P < .05) were more frequently perceived by CS and waterpipe-users than NS. There was no significant difference in perceived bleeding gums around the implant or loose implant among all groups. The CBL (P < .01), PI (P < .001), and PD (P < .01) were significantly high in CS and waterpipe-users than NS. NS (P < .05) had significantly higher BOP than waterpipe-users and CS. There was no significant difference in CBL, PI, PD, and BOP among waterpipe-users and CS. CONCLUSION Tobacco-smokers present with worse peri-implant perceived OS and clinicoradiograhic parameters than nonsmokers with peri-implantitis.
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Affiliation(s)
- Fawaz Alqahtani
- Department of Prosthodontics, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Nasser Alqhtani
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Darshan D Divakar
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Sapna B Shetty
- Department of Conservative Dentistry, Sharavathi Dental College and Hospital, Shimoga, India
| | - Bharathraj Shetty
- Department of Prosthodontics Including Crown and Bridge, AB Shetty Memorial Institutes of Dental Sciences, Mangalore, India
| | - Fahad Alkhtani
- Department of Prosthodontics, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
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Singh DK, Kumar G. Comparison of the subgingival temperature of smokers and nonsmokers in healthy and diseased sites of gingiva in association with sublingual body temperature. J Family Med Prim Care 2019; 8:3166-3172. [PMID: 31742137 PMCID: PMC6857422 DOI: 10.4103/jfmpc.jfmpc_516_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/22/2019] [Accepted: 09/10/2019] [Indexed: 01/19/2023] Open
Abstract
Background: To compare the subgingival temperature in healthy and diseased sites of gingiva in smokers and non-smokers using a modified digital thermometer. To also find whether subgingival temperature measurements can be used as reliable indicator of periodontal disease activity. Materials and Methods: Participants for this study comprised 50 males, 25 smokers and 25 non-smokers with mild to moderate periodontitis, aged 25-40 years and had four maxillary incisor teeth (12, 11, 21, 22) intact. For each participant, six sites around each tooth were examined. Hence, a total of 24 sites for each participant were examined. The clinical parameters used were probing pocket depth and gingival bleeding index. Results: Sublingual and subgingival temperature was found to be warmer in smokers compared to non-smokers. Subgingival temperature was more in diseased sites than healthy sites in both smokers and non-smokers. The mean temperature differential of diseased sites in smokers was more compared to non-smokers. Mean probing pocket depth was higher in smokers, but bleeding sites were less. Conclusion: Subgingival temperature measurement was found to be a good indicator of periodontal disease activity.
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Affiliation(s)
- Dhirendra K Singh
- Department of Periodontics and Oral Implantology, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Gunjan Kumar
- Public Health Dentistry, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
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