Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
Faculty of Dentistry, Alexandria University, Egypt.
Clin Exp Dent Res. 2021 Jun;7(3):376-384. doi: 10.1002/cre2.360. Epub 2020 Dec 4.
While tobacco cigarette smoking has been proven to be a risk factor for periodontitis, limited information is available regarding vaping, a new alternative to smoking that has been branded as less harmful. Several important in vitro studies have shown that vaping has a similarly damaging effect as cigarette smoking on the health of the periodontium. However, a comprehensive review is lacking in this field. Therefore, we aimed to systematically review the literature about the impact of vaping on periodontitis.
The research question was created using the PICOs format. A systematic search of the following electronic databases was performed up to March 2020: Medline, Embase, PubMed, Cochrane, and grey literature. Human studies that assessed periodontal status (plaque index, bleeding on probing, clinical attachment loss, marginal bone loss, and probing depth) in e-cigarette users compared to non-smokers (control group) were assessed based on an estimate of fixed effects. The weights of the studies were calculated based on their risks of bias.
After duplicates were removed, 1,659 studies were screened and 8 case-control studies that investigated the relationship between vaping and periodontal parameters in humans were selected after their risk of bias assessment. Estimated effects of vaping after weighting results based on their standard deviation showed increased plaque, marginal bone loss, clinical attachment loss, pocket depth, and reduced bleeding on probing.
This study concluded that there is not enough evidence to fully characterize the impacts of vaping on periodontitis. However, within the limitations of our review and the selected included studies, the available results point to increased destruction of the periodontium leading to the development of the disease.
虽然吸烟已被证实是牙周病的一个危险因素,但关于电子烟的信息有限,电子烟作为一种新型的吸烟替代品,被宣传为危害较小。一些重要的体外研究表明,电子烟对牙周组织的健康具有与吸烟相似的破坏性影响。然而,该领域缺乏全面的综述。因此,我们旨在系统地回顾关于电子烟对牙周病影响的文献。
研究问题采用 PICOS 格式创建。对以下电子数据库进行了系统搜索,截至 2020 年 3 月:Medline、Embase、PubMed、Cochrane 和灰色文献。评估了将电子烟使用者与非吸烟者(对照组)的牙周状况(菌斑指数、探诊出血、临床附着丧失、边缘骨丧失和探诊深度)进行比较的人类研究,其依据是固定效应的估计。根据偏倚风险评估,基于标准偏差计算了研究的权重。
在去除重复项后,筛选出 1659 项研究,在对其偏倚风险进行评估后,选择了 8 项研究,这些研究调查了电子烟与人类牙周参数之间的关系。基于标准偏差对加权结果进行估计后的效应表明,电子烟使用后菌斑、边缘骨丧失、临床附着丧失、牙周袋深度增加,探诊出血减少。
本研究得出的结论是,目前尚无足够的证据来全面描述电子烟对牙周病的影响。然而,在我们的综述和选定的纳入研究的局限性内,现有结果表明电子烟会增加牙周组织的破坏,导致疾病的发生。