The effect of conventional versus electronic cigarette use on treatment outcomes of peri-implant disease

Abstract

Aim To compare changes in clinical periodontal parameters (gingival consistency, colour, BOP, PI, PD) and changes of salivary inflammatory biomarkers (IL-1 β, IL-6, MMP-8, TNF- α and TIMP-1 between conventional, electronic cigarette smokers and non-smokers after peri-implant treatment. Methods Study participants were grouped into three groups (i) Conventional cigarette smokers (ii) Electronic cigarette smokers and (iii) non-smokers respectively. A total of 60 adult patients aged (40–56 years) with 60 implants with active per-impantitis was included.Clinical and Biological parameters were evaluated before surgical treatment at baseline, one, six and twelve month post treatment. Pearson’s chi-square test was used to compare the distribution of the categorical while Two-way repeated analysis of variance was used to compare the mean values of quantitative outcome variables among all study groups across the 4 time points. Results A total of 60 subjects (60 implants) were selected and classified into three groups as per their smoking method 20 participants in each group with one single targeted implant diagnosis with active peri-implantitis. The gingival colour, the change was statistically significant at one year of post treatment.The gingival consistency distribution across the three groups is not statistically significant at baseline, but it is statistically significant at one-month (p = 0.001), six months (p = 0.029) and at the completion of one-year (p = 0.018) post treatment. The plaque index of 100% of non-smokers had changed to ‘0’ and 35% change in cigarettes and 30% change in electronic smokers which is statistically significant (p = 0.016).The prevalence of BOP was observed in the three groups as 72%, 76.5% and 88.9% at baseline. The mean values of PD have shown statistically significant change across the three groups over the four-time intervals of observation (p = 0.024). The comparison of mean values of IL-1 β, IL-6 and TIMP-1 has shown statistically significant change across the three groups over the four intervals of observation (p < 0.0001). Conclusions Electronic cigarette smoking was found to be most prevalent risk indicator for peri-implantitis. Compromised response of peri-implantitis treatment both clinically and biologically was found more among electronic cigarette smokers when compared to conventional cigarette smokers and non-smokers. Trial registration: This case-control study was conducted at King Saud University’s Dental College, Riyadh, Saudi Arabia, in accordance with “Helsinki Declaration of Human Studies” and approved by the Institutional Review Board (Reference no: 87563).

Periodontal and Peri-Implant Health Status in Traditional vs. Heat-Not-Burn Tobacco and Electronic Cigarettes Smokers: A Systematic Review

“…A typical feature of periodontal disease associated with tobacco smoking is a greater destruction of the supporting tissues of the teeth with clinical attachment loss [ 67 ]. Many studies, reported in this review, agreed with this; in fact, Mokeem et al, BinShabaib et al, Ibraheem et al and Fangxi Xu et al described that CS had the worst CAL values compared to NS [ 50 , 54 , 58 , 65 ]. Aldakheel et al also came to the same conclusion, reporting higher CAL values in CS, E-Cigs and NS with periodontitis compared to NS without periodontitis [ 57 ].…”

“…Regarding plaque accumulation, many authors reported higher PI values in CS and E-Cigs compared to NS [ 53 , 58 , 59 , 64 ]. In more detail, Vohra et al reported that CS had the worst PI values compared to E-Cigs and NS [ 55 ]; conversely, AlJasser et al found that NS had worse plaque conditions than E-Cigs and CS [ 65 ]. Mokeem et al also found higher, although not significantly different, PI values around natural teeth in CS than E-Cigs and in E-Cigs than in, otherwise ArRejaie et al did not find any differences in PI around dental implants between CS and E-Cigs [ 50 , 60 ].…”

Salivary biomarkers as key to monitor personalized oral healthcare and precision dentistry: A scoping review

“…This is certainly also in the interest of implant manufacturers, so that financial support for research would be guaranteed. Nevertheless, the results of this Scoping Review revealed only 1 clinical trial focusing on saliva and possible association with peri-implantitis ( 21 ). In addition, dentistry could become the door-opener for routine diagnostics in medicine, e.g., assessment of glucose concentration in diabetes patients ( 84 ).…”

Impact of local predisposing/precipitating factors and systemic drivers on peri‐implant diseases

“…A systematic review concluded that smoking yielded more bone loss than any type of implant surface 124 . Recent longitudinal and cross‐sectional studies have demonstrated the detrimental impact of tobacco smoking on the stability of peri‐implant tissues 94,125–130 . During up to 22 years of following 4247 patients with 10 871 implants, heavy cigarette smoking (>10 pack years) almost doubled the risk for implant failure defined as removal for any reason (HR = 1.81) 94 .…”