Peri-implant parameters and bone metabolic markers among water-pipe users treated with photodynamic therapy

AIM

The study aimed to evaluate the efficacy of Mechanical debridement (MD) with and without adjunct antimicrobial photodynamic therapy (aPDT) in the treatment of peri‑implantitis among waterpipe smokers (WPS) and non-smokers with peri‑implantitis MATERIAL AND METHODS: Participants were stratified into two groups. Group 1: Subjects who smoked water pipes for the last 2 years with peri‑implant disease were treated with aPDT adjunct to MD and group 2: Participants who did not use water pipes in the last 2 years but have periimplantitis (controls) were treated with MD only. Participants were scrutinized with peri‑implantitis (PI) in one dental implant at least based on the inclusion and exclusion criteria. Using structured questionnaire information was gathered from participants. All participants underwent mechanical debridement (MD). Participants of WPS underwent antimicrobial photodynamic therapy (aPDT). Peri implant inflammatory parameters (PI, BI, PD, and CBL) were assessed in all participant at baseline, 3 months and 6 months follow-up. Periimplant sulcular fluid was collected for assessment of bone metabolic biomarkers RANK-L and OPG. For immunological and clinical peri‑implant parameters analysis of variance (ANOVA) and Kruskal-Wallis test were used. For multiple comparisons, Bonferroni post hoc test was deployed.

RESULTS

Clinical periodontal parameters at baseline were significantly different in the control group PI (49.8 ± 10.5), BI(46.8 ± 7.7), and PD (5.0 ± 1.8) compared to WPS PI (56.1 ± 12.0), BI (40.9 ± 8.3), and PD (5.6 ± 1.5) (p < 0.05). At 3 months follow-up after PDT, PI (19.1 ± 7.7) and PD (3.9 ± 1.4) were significantly lower in the control group compared to WPS group PI (23.5 ± 8.4) and PD (4.5 ± 1.2) (p < 0.05). Whereas, BI of control (16.3 ± 6.8) and WPS group (17.1 ± 5.3) at 3 months follow-up was comparable (p > 0.05). At six months follow up following PDT, PI (15.7 ± 5.5) and PD (3.4 ± 1.2) was significantly lower in the control group compared to participants with water piped users PI (18.6 ± 7.4) and PD (3.9 ± 1.3) (p < 0.05). No significant difference was noted in BI in both groups (p > 0.05). Participants treated with PDT adjunct to MD demonstrated significantly reduced mean RANK-L levels at both 3 and 6 months (p<0.05).

CONCLUSION

aPDT adjunctive to MD improved periodontal parameters i.e., plaque index, pocket depth, and crestal bone loss along with metabolic marker RANK-L in water pipe smokers compared to non piped smokers.

Waterpipe Tobacco Smoking among Arab Youth; a Cross-Country Study

OBJECTIVE

Waterpipe tobacco smoking (WTS) is considered a global epidemic that is spreading among youth. Our analysis was conducted to compare the national baseline prevalence rate estimates of WTS among Arab boys and girls.

DESIGN SETTING AND PARTICIPANTS

The Global Youth Tobacco Survey (GYTS) is a school-based survey using standardized self-administered questionnaires; it employs a two-stage cluster sampling technique to obtain a representative sample of youth (13-15 years of age). We conducted a secondary data analysis of nationally representative GYTSs available from 16 Arab countries.

MAIN MEASURES

Youth who self-reported smoking waterpipe at least once in the past 30 days were considered to be current waterpipe tobacco smokers. National weighted WTS prevalence rate estimates along with respective 95% confidence intervals were reported for boys and girls.

RESULTS

Pooled GYTS data from 16 Arab countries yielded a total of 31,359 youth. Overall, 10.6% of the respondents were current waterpipe tobacco smokers, with boys (13.7%) having significantly higher estimates than girls (7.2%). Overall, current WTS prevalence rate estimates ranged from .9% in Oman to 34.2%, in Lebanon. The WTS epidemic was more predominant among boys and girls, respectively, in the West Bank (42.8% and 24.2%), Lebanon (38.6% and 30.5%) and Jordan (25.7% and 14.5%).

CONCLUSION

Among Arab boys and girls, WTS represents a growing strain of the tobacco epidemic that requires immediate attention.

Waterpipe Use and Susceptibility to Cigarette Smoking Among Never-Smoking Youth

INTRODUCTION

Susceptibility to cigarette smoking, defined as the lack of a firm decision against smoking, is a strong predictor of regular smoking and addiction. Several modifiable risk factors have been identified among never cigarette smokers, and one potential factor of interest is waterpipe use. The purpose of this study is to determine the association of waterpipe use with susceptibility to cigarette smoking among never-smoking youth.

METHODS

In a pooled analysis of 17 Arab nations with nationally representative Global Youth Tobacco Surveys conducted during 2002-2011, tobacco-related information was obtained from 30,711 never-smoking adolescents representing 4,962,872 youth. Study outcome was susceptibility to cigarette smoking, and primary exposure was waterpipe use. Data were analyzed in 2014 using weighted logistic regression models, including stratified models by gender, to determine the odds of susceptibility to cigarette smoking with waterpipe use, adjusting for confounders.

RESULTS

Overall, 20% of never-smoking youth were susceptible to cigarette smoking, ranging from 13.1% in Oman to 32.6% in Somalia; 5.2% currently used waterpipe, ranging from 0.3% in Morocco to 23.5% in Kuwait. The estimated odds of susceptibility to cigarette smoking were 2.5 (95% CI=1.9, 3.4) times higher for adolescents who used waterpipe in the past month compared with those who did not, controlling for confounders. Estimates were similar when stratified by gender.

CONCLUSIONS

Waterpipe use is associated with susceptibility to cigarette smoking. Study findings identify a novel risk factor for never smokers to initiate smoking and will help the public health community develop and implement policies around waterpipe use prevention.

Mouth Cancer for Clinicians Part 3: Risk Factors (Traditional: Tobacco)

A MEDLINE search early in 2015 revealed more than 250,000 papers on head and neck cancer; over 100,000 on oral cancer; and over 60,000 on mouth cancer. Not all publications contain robust evidence. We endeavour to encapsulate the most important of the latest information and advances now employed in practice, in a form comprehensible to healthcare workers, patients and their carers. This series offers the primary care dental team, in particular, an overview of the aetiopathogenesis, prevention, diagnosis and multidisciplinary care of mouth cancer, the functional and psychosocial implications, and minimization of the impact on the quality of life of patient and family. CPD/CLINICAL RELEVANCE: This article offers the dental team an overview of the main cancer risk factors, tobacco and alcohol, betel and other chewing habits, and environmental factors.