Evaluation of the Papillary Gingival Vasculature in Smokers and Nonsmokers with Chronic Periodontitis: A Clinical In Vivo Study

The impact of electronic and conventional cigarettes on periodontal health-a systematic review and meta-analysis

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.

Modern view on mechanisms of epithelium differentiation of the oral mucosa in normal and pathological processes

Background:In everyday clinical practice, patients who seek dental care in case of oral mucosa diseases are one of the most difficult categories of patients due to difficulties in diagnosis and treatment. Materials and methods: The review and analysis of scientific and medical literature based on the Scopus, Web of Science, MedLine, PubMed, NCBI databases, the study of which does not exceed 5 years, including literature reviews and the results of clinical trials. Results: Changes in the oral mucosa can be clearly specific. Clinicians can make the correct diagnosis and determine the tactics of treatment by appearance. However, in most cases the diagnosis of diseases with this anatomical location is complicated, because the clinical picture is nonspecific and often burdened with additional local and general adverse factors. A detailed clinical examination and additional research methods are required to establish the correct diagnosis. Diagnosis of oral mucosa diseases is based on a careful assessment of clinical and laboratory data. Conclusions: Taking into account the prevalence of diseases of the oral mucosa, of particular interest is the question of the course of the process of differentiation of the epithelium of various anatomical zones in the norm and the mechanisms of restructuring of the cellular composition in pathological processes, with the cops of objectifying the diagnosis, predicting the course of the disease and pathogenetically substantiated treatment.