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Vámos O, Kulcsár N, Mikecs B, Kelemen K, Kaán R, Abafalvi L, Dinya E, Vág J, Hermann P, Kispélyi B. Acute effects of traditional and electronic cigarettes on palatal blood flow in smokers: A cross-over pilot study. J Oral Biol Craniofac Res 2024; 14:152-157. [PMID: 38333089 PMCID: PMC10850968 DOI: 10.1016/j.jobcr.2024.01.012] [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: 07/29/2023] [Revised: 12/12/2023] [Accepted: 01/19/2024] [Indexed: 02/10/2024] Open
Abstract
Background Smoking is a significant health hazard and contributes to cardiovascular and pulmonary diseases. It can increase postoperative complications during oral and maxillofacial surgery due to its topical effect on the oral mucosa. New alternatives to traditional tobacco products are gaining popularity, in particular, electronic cigarettes. Objectives This pilot study investigated the acute effects of nicotine-containing and nicotine-free electronic cigarettes on palatal blood flow (PBF), and compared their effects to traditional cigarettes. Materials and methods 14 medically healthy volunteers (8 males, 6 females, age: 34.7 ± 7.0) were recruited for the study. All patients (N = 14) were requested to smoke nicotine-containing (ECN) and nicotine-free electronic cigarettes (EC0) and a mouthpiece (end of a traditional cigarette) as a control sham smoking blind test (BT). EC users did not smoke a traditional cigarette (TC), resulting in 10 people in the TC group. Palatal blood flow was measured by Laser Speckle Contrast Imager before, immediately after, and 15 min after the exposures. Exhaled carbon monoxide (eCO) and carboxyhemoglobin (COHb) were measured before and immediately after smoking with a piCO+ Smokerlyzer machine. Results In all groups, no significant differences were observed in the changes of palatal blood flow between time points. Exhaled carbon monoxide and carboxyhemoglobin were significantly higher in the traditional cigarette (TC) group compared to the nicotine-containing electronic cigarette (ECN) and nicotine-free electronic cigarette (EC0) groups, both before and after the exposure (p < 0.05). Conclusion Acute use of either traditional or electronic cigarettes may have minimal impact on palatal blood flow, but additional studies are required to clarify their impact on the mucosa.
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Affiliation(s)
- Orsolya Vámos
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi Street 47, Budapest, H-1088, Hungary
| | - Norbert Kulcsár
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi Street 47, Budapest, H-1088, Hungary
| | - Barbara Mikecs
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi Street 47, Budapest, H-1088, Hungary
| | - Kata Kelemen
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi Street 47, Budapest, H-1088, Hungary
| | - Réka Kaán
- Department of Oral Health Sciences, KU Leuven, Oude Markt 13, 3000, Leuven, Belgium
| | - Lilla Abafalvi
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi Street 47, Budapest, H-1088, Hungary
| | - Elek Dinya
- Institute of Digital Health Sciences, Faculty of Public Services, Semmelweis University, Üllői Road 26, Budapest, H-1085, Hungary
| | - János Vág
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi Street 47, Budapest, H-1088, Hungary
| | - Péter Hermann
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi Street 47, Budapest, H-1088, Hungary
| | - Barbara Kispélyi
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi Street 47, Budapest, H-1088, Hungary
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Silva H. Tobacco Use and Periodontal Disease-The Role of Microvascular Dysfunction. BIOLOGY 2021; 10:441. [PMID: 34067557 PMCID: PMC8156280 DOI: 10.3390/biology10050441] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 12/30/2022]
Abstract
Periodontal disease consists in highly prevalent wide-ranging inflammatory conditions that affect the supporting apparatus of teeth. Tobacco use is the most important risk factor for periodontal disease as it increases disease severity and periodontal surgery complications. Tobacco use is harmful for the vasculature by causing microvascular dysfunction, which is known to negatively affect periodontal disease. To the author's knowledge this paper is the first comprehensive review on the mechanisms by which tobacco use affects oral microcirculation and impacts the pathophysiology of periodontal disease. In healthy subjects, acute nicotine administration or tobacco use (smoking/smokeless forms) increases the blood flow in the oral mucosa due to local irritation and increased blood pressure, which overcome neural- and endocrine-mediated vasoconstriction. Chronic tobacco smokers display an increased gingival microvascular density, which is attributed to an increased capillary recruitment, however, these microcirculatory units show higher tortuosity and lower caliber. These morphological changes, together with the repetitive vasoconstrictive insults, contribute to lower gingival perfusion in chronic smokers and do not completely regress upon smoking cessation. In periodontal disease there is considerable gingival inflammation and angiogenesis in non-smokers which, in chronic smokers, are considerably suppressed, in part due to local immune suppression and oxidative stress. Tobacco exposure, irrespective of the form of use, causes long-term microvascular dysfunction that increases the risk of complications due to the natural disease course or secondary therapeutic strategies.
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Affiliation(s)
- Henrique Silva
- Informetrics Research Group, Ton Duc Thang University, Ho Chi Minh City 758307, Vietnam;
- Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City 758307, Vietnam
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Fujii N, Louie JC, McNeely BD, Zhang SY, Tran MA, Kenny GP. Nicotinic receptor activation augments muscarinic receptor-mediated eccrine sweating but not cutaneous vasodilatation in young males. Exp Physiol 2016; 102:245-254. [DOI: 10.1113/ep085916] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 11/15/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Naoto Fujii
- Human and Environmental Physiology Research Unit, School of Human Kinetics; University of Ottawa; Ottawa Ontario Canada
| | - Jeffrey C. Louie
- Human and Environmental Physiology Research Unit, School of Human Kinetics; University of Ottawa; Ottawa Ontario Canada
| | - Brendan D. McNeely
- Human and Environmental Physiology Research Unit, School of Human Kinetics; University of Ottawa; Ottawa Ontario Canada
| | - Sarah Y. Zhang
- Human and Environmental Physiology Research Unit, School of Human Kinetics; University of Ottawa; Ottawa Ontario Canada
| | - My-An Tran
- Human and Environmental Physiology Research Unit, School of Human Kinetics; University of Ottawa; Ottawa Ontario Canada
| | - Glen P. Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics; University of Ottawa; Ottawa Ontario Canada
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Nolan MB, Warner DO. Safety and Efficacy of Nicotine Replacement Therapy in the Perioperative Period: A Narrative Review. Mayo Clin Proc 2015; 90:1553-61. [PMID: 26455889 DOI: 10.1016/j.mayocp.2015.08.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 07/27/2015] [Accepted: 08/06/2015] [Indexed: 12/23/2022]
Abstract
Patients who smoke cigarettes are at increased risk for development of complications both during and after surgical procedures, including respiratory, cardiac, and healing-related complications. Abstinence from smoking can considerably reduce these risks. Pharmacotherapy, including nicotine replacement therapy (NRT), is an important component of efficacious tobacco use interventions. However, the use of NRT in the perioperative period is controversial. In this narrative review, we discuss the current evidence for the efficacy and safety of NRT in patients scheduled for surgical procedures, with emphasis on evidence from human studies. We performed a literature search for articles published from January 1, 1990, through May 1, 2015, in the PubMed online database using various permutations of the Medical Subject Headings terms surgery; surgical procedures, operative; nicotine; and smoking cessation. Studies were selected for inclusion according to their relevance to the preclinical and clinical evidence pertaining to how NRT affects surgical outcome and long-term rates of abstinence from tobacco. There is strong evidence that NRT enhances the efficacy of tobacco use interventions. Some preclinical studies suggest that nicotine in high doses that exceed those produced by NRT decreases the viability of skin flaps. Although the available data are limited, there is no evidence from human studies that NRT increases the risk of healing-related or cardiovascular complications. Individual clinical trials of tobacco use interventions that include NRT have revealed either no effect or a reduction in complication rates. Therefore, given the benefits of smoking abstinence to both perioperative outcomes and long-term health and the efficacy of NRT in achieving and maintaining abstinence, any policies that prohibit the use of NRT in surgical patients should be reexamined.
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Affiliation(s)
| | - David O Warner
- Department of Anesthesiology, Mayo Clinic, Rochester, MN
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Moyen NE, Anderson HM, Burchfield JM, Tucker MA, Gonzalez MA, Robinson FB, Ganio MS. Forearm cutaneous vascular and sudomotor responses to whole body passive heat stress in young smokers. Am J Physiol Regul Integr Comp Physiol 2015; 309:R36-42. [PMID: 25924880 DOI: 10.1152/ajpregu.00079.2015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 04/23/2015] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to compare smokers and nonsmokers' sudomotor and cutaneous vascular responses to whole body passive heat stress. Nine regularly smoking (SMK: 29 ± 9 yr; 10 ± 6 cigarettes/day) and 13 nonsmoking (N-SMK: 27 ± 8 yr) males were passively heated until core temperature (TC) increased 1.5°C from baseline. Forearm local sweat rate (LSR) via ventilated capsule, sweat gland activation (SGA), sweat gland output (SGO), and cutaneous vasomotor activity via laser-Doppler flowmetry (CVC) were measured as mean body temperature increased (ΔTb) during passive heating using a water-perfused suit. Compared with N-SMK, SMK had a smaller ΔTb at the onset of sweating (0.52 ± 0.19 vs. 0.35 ± 0.14°C, respectively; P = 0.03) and cutaneous vasodilation (0.61 ± 0.21 vs. 0.31 ± 0.12°C, respectively; P < 0.01). Increases in LSR and CVC per °C ΔTb (i.e., sensitivity) were similar in N-SMK and SMK (LSR: 0.63 ± 0.21 vs. 0.60 ± 0.40 Δmg/cm(2)/min/°C ΔTb, respectively, P = 0.81; CVC: 82.5 ± 46.2 vs. 58.9 ± 23.3 Δ%max/°C ΔTb, respectively; P = 0.19). However, the plateau in LSR during whole body heating was higher in N-SMK vs. SMK (1.00 ± 0.13 vs. 0.79 ± 0.26 mg·cm(-2)·min(-1); P = 0.03), which was likely a result of higher SGO (8.94 ± 3.99 vs. 5.94 ± 3.49 μg·gland(-1)·min(-1), respectively; P = 0.08) and not number of SGA (104 ± 7 vs. 121 ± 9 glands/cm(2), respectively; P = 0.58). During whole body passive heat stress, smokers had an earlier onset for forearm sweating and cutaneous vasodilation, but a lower local sweat rate that was likely due to lower sweat output per gland. These data provide insight into local (i.e., forearm) thermoregulatory responses of young smokers during uncompensatory whole body passive heat stress.
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Affiliation(s)
- Nicole E Moyen
- Human Performance Laboratory, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, Arkansas
| | - Hannah M Anderson
- Human Performance Laboratory, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, Arkansas
| | - Jenna M Burchfield
- Human Performance Laboratory, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, Arkansas
| | - Matthew A Tucker
- Human Performance Laboratory, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, Arkansas
| | - Melina A Gonzalez
- Human Performance Laboratory, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, Arkansas
| | - Forrest B Robinson
- Human Performance Laboratory, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, Arkansas
| | - Matthew S Ganio
- Human Performance Laboratory, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, Arkansas
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Fujii N, Brunt VE, Minson CT. Tempol improves cutaneous thermal hyperemia through increasing nitric oxide bioavailability in young smokers. Am J Physiol Heart Circ Physiol 2014; 306:H1507-11. [PMID: 24682395 DOI: 10.1152/ajpheart.00886.2013] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
We recently found that young cigarette smokers display cutaneous vascular dysfunction relative to nonsmokers, which is partially due to reduced nitric oxide (NO) synthase (NOS)-dependent vasodilation. In this study, we tested the hypothesis that reducing oxidative stress improves NO bioavailability, enhancing cutaneous vascular function in young smokers. Ten healthy young male smokers, who had smoked for 6.3 ± 0.7 yr with an average daily consumption of 9.1 ± 0.7 cigarettes, were tested. Cutaneous vascular conductance (CVC) during local heating to 42°C at a rate of 0.1°C/s was evaluated as laser-Doppler flux divided by mean arterial blood pressure and normalized to maximal CVC, induced by local heating to 44°C plus sodium nitroprusside administration. We evaluated plateau CVC during local heating, which is known to be highly dependent on NO, at four intradermal microdialysis sites with 1) Ringer solution (control); 2) 10 μM 4-hydroxy-2,2,6,6-tetramethylpiperidine-1-oxyl (tempol), a superoxide dismutase mimetic; 3) 10 mM N(ω)-nitro-l-arginine (l-NNA), a nonspecific NOS inhibitor; and 4) a combination of 10 μM tempol and 10 mM l-NNA. Tempol increased plateau CVC compared with the Ringer solution site (90.0 ± 2.3 vs. 77.6 ± 3.9%maximum, P = 0.028). Plateau CVC at the combination site (56.8 ± 4.5%maximum) was lower than the Ringer solution site (P < 0.001) and was not different from the l-NNA site (55.1 ± 4.6%maximum, P = 0.978), indicating the tempol effect was exclusively NO dependent. These data suggest that in young smokers, reducing oxidative stress improves cutaneous thermal hyperemia to local heating by enhancing NO production.
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Affiliation(s)
- Naoto Fujii
- Department of Human Physiology, The University of Oregon, Eugene, Oregon
| | - Vienna E Brunt
- Department of Human Physiology, The University of Oregon, Eugene, Oregon
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