ABSTRACT
Electric cigarette is currently popular among smokers and it is used as an alternative for smoking cessation because it seems safer than tobacco cigarettes. This study aimed to present the existing literature regarding the effect of electric smoking on the severity of chronic periodontitis. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping review guidelines was followed. Articles were retrieved from PubMed, Google Scholar, and WILEY databases and screened to include studies relating to the effect of electric smoking on periodontal health. Eleven papers were included. The articles were allocated to five different topics: the safety of electric smoking on periodontal tissue, the effect of electric cigarettes on periodontal clinical status, inflammatory response, gingival crevicular fluid volume, and gingival fibroblast. Electric smoking could increase the prevalence of periodontal disease. There are no differences in the score at the loss of attachment, pocket depth, and alveolar bone loss between electric smokers and tobacco smokers. The nicotine in the electric liquid increases the expression of Advanced Glycation End Products (AGEs) and Receptor for Advanced Glycation End Products (RAGEs). Interaction between AGEs and RAGEs plays a role in the etiopathogenesis of periodontitis. Electric smoking will increase the expression of inflammatory cytokines; Interleukin-6 (IL-6), Interleukin-ß (IL-ß), and Tumor Necrosis Factor-α (TNF-α) in gingival crevicular fluid. A high concentration of inflammatory cytokines has an impact on alveolar bone destruction. It is important to identify the component of electric cigarettes and their effect on periodontal tissue. E-liquid in electric cigarettes contains low levels of nicotine, propylene glycol, vegetable glycerin, and artificial flavor. Electric smoking has contributed to pro-inflammatory responses. E-cigarette smoking will increase the expression of inflammatory cytokines and protein carbonylation that causes alveolar bone destruction. Several factors such as the history of using tobacco smoke, frequency of electric smoking, the nicotine concentration in e-liquid, age, and maintenance of oral hygiene are the factor that can affect the variation of studies about the effect of electric smoking on the severity of chronic periodontitis.
