The impact of e-cigarette use on periodontal health: a systematic review and meta-analysis
Bibliographic record
Abstract
BACKGROUND: Electronic Nicotine Delivery Systems (ENDS, e-cigarettes) are a popular alternative to traditional tobacco smoking. OBJECTIVE: To evaluate the effect of ENDS use on periodontal health. METHODS: A protocol was published in accordance with PRISMA standards. Subjects with periodontal health, gingivitis and periodontitis were included. Reviews, case reports, letters, abstracts, narratives and expert opinions were excluded. Databases searched included PubMed, Embase, Web of Science, CINAHL Plus, and Dentistry & Oral Sciences Source up until February 2024. Risk of bias was evaluated using the Newcastle-Ottawa Scale, ROBINS-I and the RoB 2 tools. RESULTS: 40 eligible studies were included. Smokers had poorer clinical outcomes than ENDS users and non-smokers/former smokers, apart from bleeding on probing and gingival indices. There was no difference between ENDS users and non-smokers/former smokers in markers of periodontal destruction (pocket probing depths/marginal bone loss). ENDS users had higher plaque scores than non-smokers/former smokers. ENDS use leads to unique microbial changes compared to tobacco smokers and higher pro-inflammatory markers compared to non-smokers/former smokers. CONCLUSION: Within the limitations of the included studies which are at high risk of bias, we found evidence that ENDS use had some impact on periodontal parameters compared to non-smokers/former smokers. Tobacco smokers had consistently worst outcomes. REGISTRATION PROSPERO 2024: CRD42024496560.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.039 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.030 |
| Bibliometrics | 0.008 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".