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Vámos O, Komora P, Gede N, Hegyi P, Kelemen K, Varga G, Mikulás K, Kerémi B, Kispélyi B. The Effect of Nicotine-Containing Products on Peri-Implant Tissues: A Systematic Review and Network Meta-Analysis. Nicotine Tob Res 2024; 26:1276-1285. [PMID: 38618685 PMCID: PMC11417124 DOI: 10.1093/ntr/ntae085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/16/2024]
Abstract
INTRODUCTION Smokers have a higher chance of developing peri-implant diseases and are therefore considered an at-risk population. Our aim was to compare peri-implant characteristics in users of electronic cigarettes (EC), waterpipes (WP), cigarettes (CS), smokeless tobacco (ST), and nonsmokers (nonusers of any nicotine and tobacco product; NS). AIMS AND METHODS A systematic search of four electronic databases (PubMed, EMBASE, Web of Science, and CENTRAL) was performed until April 2023, restricted to English language. Thirty-nine observational studies were included in the qualitative synthesis, of which 32 studies were included in a Bayesian network meta-analysis. Using a predesigned form, two researchers independently collected data about marginal bone loss (MBL), probing pocket depth (PPD), plaque index, bleeding on probing, modified plaque index, probing pocket depth > 4 mm (PPD > 4), gingival index, peri-implant sulcular fluid volume, and TNF-α and IL-1β levels. QUIPS and CINeMA were used to evaluate the risk of bias and certainty of evidence. RESULTS Nonsmokers had the smallest MBL. Most nicotine-containing product users had significantly higher MBL (CS, mean difference [MD]: 1.34 credible interval [CrI]: 0.85, 1.79; WP, MD: 1.58 CrI: 0.84, 2.35; ST, MD: 2.53, CrI: 1.20, 3.87) than NS. Electronic cigarettes did not show significant difference compared to NS (MD: 0.52 CrI: -0.33, 1.36). In secondary outcomes, NS were ranked in first place. Subset analysis based on smoking habit, implant duration, and maintenance control revealed no differences in ranking probability. CONCLUSIONS Most nicotine-containing product users presented worse peri-implant parameters compared to NS, while EC users did not show significant differences to NS in many outcomes. IMPLICATIONS Alternative nicotine-containing products are gaining popularity and are often considered less harmful by the general public compared to traditional cigarettes. This is the first network meta-analysis comparing users of four nicotine-containing products and NS. This study shows that CS, WP, and ST have a detrimental effect on the overall health of peri-implant tissues. EC users also presented inferior parameters compared to NS; however, the difference was not significant in many outcomes. It is essential to educate patients who are using nicotine-containing products, and to provide proper maintenance and appropriate cessation support. Well-designed multiarmed studies are needed for direct comparison of different products, including heated tobacco products. Greater transparency of confounding factors is needed regarding smoking habit and oral hygiene.
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Affiliation(s)
- Orsolya Vámos
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Komora
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary
| | - Noémi Gede
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Kata Kelemen
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Gábor Varga
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Oral Biology, Semmelweis University, Budapest, Hungary
| | - Krisztina Mikulás
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Beáta Kerémi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary
| | - Barbara Kispélyi
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
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Karambelkar MV, Varma S, Suragimath G, Zope SA, Mashalkar VS, Kale AV. Comparative Evaluation of Salivary Cathelicidin and 8-Isoprostane Levels Among Smokeless Tobacco Users and Non-users and Their Correlation With Periodontal Health and Disease: A Cross-Sectional Study. Cureus 2024; 16:e67646. [PMID: 39314598 PMCID: PMC11417437 DOI: 10.7759/cureus.67646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Accepted: 08/23/2024] [Indexed: 09/25/2024] Open
Abstract
Introduction Periodontal diseases arise from host-microbial interactions influenced by tobacco products. Salivary antimicrobial peptides such as salivary cathelicidin and prostaglandins such as 8-isoprostane are part of the inflammatory cascade affecting periodontal disease pathogenesis. Methodology A total of 93 patients, 31 in each group that is healthy, periodontitis, and periodontitis with smokeless tobacco habit patients, were enrolled. The case history was recorded, and clinical examination was performed using periodontal parameter analysis of oral hygiene index simplified (OHIS), Russell's index, periodontal pocket depth (PPD), and clinical attachment level (CAL). The saliva samples were collected and subjected to an enzyme-linked immunosorbent assay (ELISA) to evaluate cathelicidin and 8-isoprostane. The results were analysed and compared statistically. Results The OHIS, Russell's index, pocket probing depth, and CAL were high in patients with periodontitis and tobacco habit (p<0.001). The cathelicidin levels were the highest in patients with periodontitis and the tobacco habit (1.6 g/mL). The level of 8-isoprostane was the highest in patients with periodontitis with tobacco habit (1.8 pg/mL). Smokeless tobacco users showed higher levels of cathelicidin and 8-isoprostane in periodontitis with tobacco than in the healthy group. Conclusion Increased cathelicidin and 8-isoprostane levels in smokeless tobacco users with periodontitis suggest risk biomarkers for tobacco-influenced periodontitis.
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Affiliation(s)
- Mugdha V Karambelkar
- Periodontology, School of Dental Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND
| | - Siddhartha Varma
- Periodontology, School of Dental Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND
| | - Girish Suragimath
- Periodontology, School of Dental Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND
| | - Sameer A Zope
- Periodontology, School of Dental Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND
| | - Vaishali S Mashalkar
- Periodontology, School of Dental Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND
| | - Apurva V Kale
- Periodontology, School of Dental Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND
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La Rosa GRM, Di Stefano A, Gangi D, Emma R, Fala V, Amaliya A, Yilmaz HG, Lo Giudice R, Pacino SA, Pedullà E, Górska R, Kowalski J, Polosa R. Dental plaque quantitation by light induced fluorescence technology in exclusive Electronic Nicotine Delivery Systems (ENDS) users. J Dent 2024; 147:105223. [PMID: 38987079 DOI: 10.1016/j.jdent.2024.105223] [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: 06/05/2024] [Revised: 06/27/2024] [Accepted: 06/29/2024] [Indexed: 07/12/2024] Open
Abstract
OBJECTIVES In comparison to conventional combustible cigarettes, Electronic Nicotine Delivery Systems (ENDS) including both e-cigarettes (ECs) and heated tobacco products (HTPs) significantly reduce exposure to toxic chemical emissions. However, their impact on dental plaque remains unclear. This study measures dental plaque in ENDS (ECs and HTPs) users using quantitative light-induced fluorescence (QLF) technology, comparing them with current, former, and never smokers. METHODS This cross-sectional study compared dental plaque measurements using QLF technology (Q-ray cam™ Pro) among current smokers (≥10 cigarettes/day), former smokers (quit ≥6 months), never smokers, and exclusive ENDS users (quit ≥6 months). Dental plaque measurements were expressed as ΔR30 (total area of mature dental plaque) and ΔR120 (greater plaque thickness/maturation-calculus). The Simple Oral Hygiene (SOH) score was calculated by the QLF proprietary software. Statistical analyses including ANCOVA was performed by R version (4.2.3) with p < 0.05. RESULTS A total 30 smokers, 24 former smokers, 29 never smokers, and 53 ENDS users were included. Current smokers had significantly higher ΔR30 and ΔR120 values compared to other groups (p < 0.001). ENDS users showed plaque levels similar to never and former smokers (p > 0.05) but significantly lower than current smokers (p < 0.01). Although ENDS users showed a lower SOH score than smokers, this difference was not statistically significant. Daily toothbrushing and mouthwash usage were significant covariates. CONCLUSION ENDS users exhibited reduced accumulation of dental plaque and calculus compared with current smokers. CLINICAL SIGNIFICANCE Exclusive ENDS use could less impact dental plaque accumulation compared to cigarette smoking. Further research is needed to confirm these findings and fully understand ENDS impact on dental plaque formation.
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Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of Clinical and Experimental Medicine, University of Catania, Italy; Department of General Surgery and Medical-Surgical Specialties, University of Catania, Italy.
| | | | | | - Rosalia Emma
- Department of Clinical and Experimental Medicine, University of Catania, Italy; Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Italy
| | - Valeriu Fala
- Faladental, Chișinău, Republic of Moldova; "Nicolae Testemiţanu" State University of Medicine and Pharmacy, Chişinău, Republic of Moldova
| | - Amaliya Amaliya
- Department of Periodontology, Faculty of Dentistry, Universitas Padjadjaran, West Java, Indonesia
| | - Hasan Guney Yilmaz
- Near East University, Faculty of Dentistry. Department of Periodontology. Nicosia, Mersin10, Turkey
| | - Roberto Lo Giudice
- Department of Human Pathology of Adults and Developmental Age, University of Messina, Italy
| | - Sebastiano Antonio Pacino
- Addendo srl, Dental Clinic, Catania, Italy; ECLAT Srl, Spin-off of the University of Catania, Catania, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Italy; Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Italy
| | - Renata Górska
- Department of Periodontology, Medical University of Warsaw, Warsaw, Poland
| | - Jan Kowalski
- Department of Periodontology, Medical University of Warsaw, Warsaw, Poland
| | - Riccardo Polosa
- Department of Clinical and Experimental Medicine, University of Catania, Italy; Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Italy
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Wiesmann-Imilowski N, Becker P, Gielisch MW, Ziebolz D, Vermehren F, Bitschnau M, Langguth N, Brieger J, Deschner J, Kämmerer PW. Cytotoxic impact of nicotine products on periodontal ligament cells. Clin Oral Investig 2024; 28:399. [PMID: 38922383 PMCID: PMC11208192 DOI: 10.1007/s00784-024-05797-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 06/20/2024] [Indexed: 06/27/2024]
Abstract
OBJECTIVES The primary objective of this in vitro experiment was an assessment of proliferative capacity, metabolic activity, and potential cellular detriment of human periodontal ligament cells (hPDL) exposed to cigarette smoke (CS), electronic cigarette vapor (eCV), and heated tobacco product aerosol (HTP), or air (control). MATERIALS AND METHODS Using a CAD/CAM-designed exposition chamber, hPDL were exposed to CS, eCV, HTP, or air (control) based on the Health Canada Intense Smoking Regime. Cell proliferation, metabolic activity, and cellular detriment were assessed at various time points. RESULTS Compared to the control, hPDL exposed to CS exhibited significantly decreased cell numbers at all time points. HTP exposure led to reduced cell numbers 48 h and 72 h post-exposure, while eCV-exposed cells showed no significant decrease. The metabolic activity of eCV-treated hPDL was slightly reduced at 7 h but recovered at 24 h and 48 h. In contrast, CS-treated cells exhibited significantly decreased metabolic activity at 24 h and 48 h, and HTP-exposed cells showed a significant decrease after 48 h. Flow cytometry indicated both apoptotic and necrotic cell death following CS exposure, with necrotic cell death being more pronounced. CONCLUSIONS eCV and HTP demonstrated comparatively reduced detrimental effects on hPDL compared to CS. CLINICAL RELEVANCE The findings suggest that conventional cigarette smoke poses a substantial risk to periodontal health by significantly impairing cell proliferation and metabolic activity. However, alternatives such as eCV and HTP may offer a comparatively reduced risk.
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Affiliation(s)
- Nadine Wiesmann-Imilowski
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Philipp Becker
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
- Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Ruebenacherstr. 170, 56072, Koblenz, Germany
| | - Matthias W Gielisch
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103, Leipzig, Germany
| | - Franziska Vermehren
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Marian Bitschnau
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Nils Langguth
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Jürgen Brieger
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center, Johannes Gutenberg University Mainz, Augustusplatz 2, 55131, Mainz, Germany.
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Mišković I, Kuiš D, Špalj S, Pupovac A, Prpić J. Periodontal Health Status in Adults Exposed to Tobacco Heating System Aerosol and Cigarette Smoke vs. Non-Smokers: A Cross-Sectional Study. Dent J (Basel) 2024; 12:26. [PMID: 38392230 PMCID: PMC10887685 DOI: 10.3390/dj12020026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/21/2024] [Accepted: 01/24/2024] [Indexed: 02/24/2024] Open
Abstract
Tobacco heating systems (THS) are new products on the market, advertised as a less harmful alternative for smokers, in which tobacco is heated and not burned like in conventional cigarettes. This research explored the effect on periodontal tissues in contact with heating and burning tobacco residual products (smoke and tobacco). METHODS The sample included 66 subjects, patients of the Clinic of Dentistry in Rijeka, Croatia, aged 26-56 (median 38), 64% females. Three age- and gender-matched groups were formed (each N = 22): non-smokers, classic cigarettes smokers and THS smokers. Probing depth (PD) and clinical attachment loss (CAL) were primary research parameters. RESULTS Three groups differed in average PD and CAL (p ≤ 0.002), with cigarette smokers having the highest and non-smokers the lowest values (p ≤ 0.002). THS consumers generally had lower values of periodontal indices than smokers, but only CAL differed significantly (p = 0.011). Periodontal indices CAL and PD were worse in THS consumers than non-smokers, but they did not reach a level of statistical significance. Cigarette smoking was the only predictor of periodontitis (average CAL ≥ 4 mm) in logistic regression models, with an odds ratio of 4.7 (95% confidence interval 1.2-18.3; p = 0.027). CONCLUSIONS Exposure to nicotine-containing aerosol of THS in adults has a less harmful effect on periodontal tissues, measurable through periodontal indices (PD and CAL), compared to burning tobacco of conventional cigarettes. THS, presented as an alternative product to classic cigarettes, also has a detrimental effect on the periodontium.
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Affiliation(s)
- Ivana Mišković
- Clinical Hospital Centre Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
| | - Davor Kuiš
- Clinical Hospital Centre Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
- Department of Periodontology, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40-42, 51000 Rijeka, Croatia
- Department of Dental Medicine, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia
| | - Stjepan Špalj
- Clinical Hospital Centre Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
- Department of Dental Medicine, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia
- Department of Orthodontics, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40-42, 51000 Rijeka, Croatia
| | - Aleksandar Pupovac
- Department of Periodontology, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40-42, 51000 Rijeka, Croatia
| | - Jelena Prpić
- Clinical Hospital Centre Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
- Department of Periodontology, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40-42, 51000 Rijeka, Croatia
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Welti R, Jones B, Moynihan P, Silva M. Evidence pertaining to modifiable risk factors for oral diseases: an umbrella review to Inform oral health messages for Australia. Aust Dent J 2023; 68:222-237. [PMID: 37649239 DOI: 10.1111/adj.12972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2023] [Indexed: 09/01/2023]
Abstract
The aim of this umbrella review was to collate and appraise the evidence base regarding modifiable risk factors for the prevention of oral diseases to inform the update of the Oral Health Messages for Australia. Eleven questions related to modifiable risk factors and dental disease were investigated. Electronic databases (Medline, Embase and PubMed) were searched from January 2010 to October 2022. Systematic reviews evaluating interventions/exposures in healthy subjects from high-income countries, where Westernized practices, oral health promotion and healthcare systems are similar to Australia, were included. Quality appraisal of included systematic reviews was guided by the AMSTAR tool. Of the 3637 articles identified, 29 articles met eligibility criteria. High-quality systematic reviews were identified for questions relating to diet, infant feeding, dental check-ups and oral hygiene. Free sugars consumption above 5% of energy intake, infrequent toothbrushing, smoking/vaping and alcohol intake were consistently associated with poorer oral health outcomes. Breastfeeding up to the age of 24 months was not associated with an increased risk of early childhood caries. The use of interdental cleaning devices and mouthguards during contact sports are likely to be effective in preventing dental disease.
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Affiliation(s)
- Rachelle Welti
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
- Inflammatory Origins, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Bree Jones
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
- Inflammatory Origins, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Paula Moynihan
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Mihiri Silva
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
- Inflammatory Origins, Murdoch Children's Research Institute, Parkville, Victoria, Australia
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Kumar S, Shlossman M. Does e-cigarette use affect response to non-surgical periodontal therapy? Evid Based Dent 2023; 24:179-180. [PMID: 37872276 PMCID: PMC10724059 DOI: 10.1038/s41432-023-00947-8] [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: 10/11/2023] [Accepted: 10/11/2023] [Indexed: 10/25/2023]
Abstract
DESIGN Cross-sectional study CASE SELECTION: Consecutive patient charts (n = 220) at Guy's Dental Hospital between April 2018 and April 2020 were included. The inclusion criteria were adults ≥18 years with a diagnosis of periodontitis (localized or generalized, all stages and grades) and who have received professional mechanical plaque removal (PMPR) by periodontology graduate students. Data of periodontal indices before and after PMPR (6-20 weeks) were also needed to be available. Exclusion criteria included uncontrolled diabetes, pregnancy, medications attributed to drug induced overgrowth, among others. DATA ANALYSIS This retrospective study evaluated the response to periodontal treatment in e-cigarette users and they compared the outcomes to non-smokers, former and current smokers. The primary outcome to evaluate the response to periodontal therapy was 'need for surgery'. This was defined by the authors as the number of sextants with ≥2 non-adjacent sites with probing depth (PD) ≥ 5 mm after PMPR. Secondary outcomes included periodontal parameters such as number of sextants with ≥1 site with PD ≥ 5 mm, PD, clinical attachment level (CAL), bleeding on probing, recession, and plaque scores. RESULTS E-cigarette users and current smokers had similar poorer clinical response to periodontal therapy. Analysis revealed e-cigarette users had more sextants with 'need for surgery' as the primary outcome. Pocket closure outcome (PD ≤ 4 mm with no bleeding on probing) were highest in nonsmokers (77.1%), followed by former smokers (74.9%), current smokers (69.4%), and e-cigarette users (66.6%). CONCLUSIONS E-cigarette users showed less than beneficial response to periodontal therapy compared to non-smokers, who had the best outcome overall.
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Affiliation(s)
- Satish Kumar
- Arizona School of Dentistry & Oral Health, Mesa, AZ, USA.
| | - Marc Shlossman
- Arizona School of Dentistry & Oral Health, Mesa, AZ, USA
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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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Pesce P, Mijiritsky E, Canullo L, Menini M, Caponio VCA, Grassi A, Gobbato L, Baldi D. An Analysis of Different Techniques Used to Seal Post-Extractive Sites—A Preliminary Report. Dent J (Basel) 2022; 10:dj10100189. [PMID: 36285999 PMCID: PMC9600503 DOI: 10.3390/dj10100189] [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: 09/08/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 12/05/2022] Open
Abstract
Background: Bone grafting in post-extractive site improves tissue regeneration. Soft tissue sealing of the grafted post-extractive alveolus is supposed to limit microbiological contamination from the oral cavity and to stabilize the coagulum. Several techniques are presented in the literature to reach this goal using different heterologous matrices or autogenous grafts. In addition, recently, a technique based on the use of granulation tissue in the post-extractive alveolus has been proposed. Aim: To compare the effect of different graft sealing approaches in post-extractive sites by qualitatively evaluating their healing process. Materials and Methods: This retrospective investigation included 30 patients requiring post-extractive site regeneration in the aesthetic area. Post-extractive sites were regenerated using a bovine bone matrix and patients were divided into three groups (10 patients in each group) according to the material used to seal the alveolar socket. In the UD group, the granulation tissue was used to seal the defect; in the PC group, epithelial-connective soft tissue graft was used, and in the COLL group, a collagen-based membrane was employed. Images of the post-extractive sites at different follow-up periods (2 and 12 weeks) were taken and the healing process was blindly evaluated by two independent practitioners. The Healing Index (HI) by Landry, Turnbull and Howley was used to assess the quality of the healing process. The combination of presence/absence of five clinical criteria defines an HI ranging from 1 (very poor) to 5 (excellent). Patients’ clinical-pathological variables were recorded. One-way ANOVA was used to explore the dependence of HI on the different socket preservation protocols. Results: Based on clinical-pathological characteristics of the included patients, there were no statistically significant differences among the different sealing techniques. At the 2-week follow-up appointment, HI did not differ among the socket preservation protocols evaluated. Moreover, smoking status and reason for extraction did not influence the HI among the three groups (two-way ANOVA p-value = 0.686, p-value = 0.248 respectively). At the 2-week follow-up appointment, HI was significantly different among the socket preservation protocols investigated. Specifically, the group undergoing collagen-based socket preservation procedure reported the highest HI, compared to the other two techniques (COLL mean 4.60 ± 0.5; PC mean 3.5 ± 1.2; UD mean 3.4 ± 0.5, one-way ANOVA p-value 0.006). Conclusions: The use of collagen porcine membranes may represent a suitable option to improve the patient healing process in grafted post-extractive sites together with reducing the surgical intervention time compared to alternative sealing techniques.
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Affiliation(s)
- Paolo Pesce
- Department of Surgical Sciences, University of Genova, 16100 Genoa, Italy
| | - Eitan Mijiritsky
- Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6139001, Israel
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Luigi Canullo
- Department of Surgical Sciences, University of Genova, 16100 Genoa, Italy
| | - Maria Menini
- Department of Surgical Sciences, University of Genova, 16100 Genoa, Italy
| | | | | | | | - Domenico Baldi
- Department of Surgical Sciences, University of Genova, 16100 Genoa, Italy
- Correspondence:
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