Do e-cigarettes have a part to play in peri-implant diseases?

Introduction:
This text is a commentary on a systematic review and meta-analysis examining the impact of e-cigarette use on peri-implant diseases in men. The authors summarize the study design, major findings, and implications of the review.

Key Points:

* The systematic review included four cross-sectional studies with male participants only.
* Meta-analysis was performed to compare e-cigarette users to never-smokers regarding peri-implant radiographic and clinical conditions as well as pro-inflammatory cytokines.
* E-cigarette users showed worse outcomes compared to never-smokers, including increased bone loss, probing depth, plaque index, and bleeding on probing, as well as increased levels of inflammatory cytokines.
* The number of participants ranged from 63 to 92, with a mean age of 39 years old.
* Mean reported e-cigarette use was 5 years with an average frequency of 6 times per day.
* all studies identified statistically significant increases in radiographic bone loss around implants in e-cigarette users when compared to never-smokers.
* The e-cigarette group had a greater plaque index, higher percentage of periodontal depth over 4 mm, less bleeding on probing, higher volume of peri-implant sulcular fluid, and increased pro-inflammatory markers.

Main Message:
The main message of this commentary is that e-cigarettes appear to have a negative impact on dental implant outcomes in male patients. The study design was well-conducted, but there are limitations to the generalizability of the findings due to the exclusion of patients taking non-steroidal anti-inflammatory drugs and the lack of information on the type of implant prosthesis. additionally, e-cigarette use status was self-reported, and there was no comparison between e-cigarettes and standard cigarettes. Therefore, further research is needed to establish the true effect of e-cigarettes on implant success or failure rates. however, based on the current evidence, caution should be applied when recommending e-cigarettes as a smoking cessation method for patients with dental implants.

Baniulyte G, ali K. Do e-cigarettes have a part to play in peri-implant diseases? Evidence-based dentistry. 2023;24(1):7-8. doi:10.1038/s41432-023-00864-w