Decoding different oxidative stress pathways in periodontitis: a comparative review of mechanisms of traditional tobacco smoke and electronic smoke aerosol.

Tobacco smoking involves the use of devices such as pipes, cigars, or cigarettes to inhale and exhale smoke from burning tobacco leaves, primarily to ingest nicotine and other substances. The impact of oxidative stress from smoking on periodontitis and its underlying mechanisms remains poorly understood. Previous research has shown that smoking activates oxidative stress responses, generating harmful oxidative substances and free radicals that induce periodontitis. Although traditionally recognized as a key pathway, recent studies suggest additional mechanisms are involved. The study aims to conduct a comprehensive review of the literature on periodontitis induced by oxidative stress from smoking, exploring potential mechanisms involving microorganisms, inflammation, immunity, cellular responses, and saliva. The primary objective is to compare and elucidate the various mechanisms by which traditional tobacco smoke and electronic cigarettes induce oxidative stress and lead to periodontitis and summarize the similarities or differences between the two. In addition, this article explores the different effects of smoking on oxidative stress and periodontitis under different conditions of nicotine presence and nicotine content. This comprehensive review contributes to our evolving understanding of how traditional tobacco smoke and electronic cigarettes affect periodontitis through different pathways and components, emphasizing that oxidative stress is an important factor in smoking-induced periodontitis. The insights gained from this study may help develop targeted interventions for the different pathways of the impact of traditional tobacco smoke and electronic cigarettes in clinical practice, to prevent or treat smoking-induced periodontitis and ultimately safeguard public oral health.