Electronic Nicotine Delivery Systems and their Effect in Periodontal Tissue and the Orofacial Region. A Review

2018 • Volume 12 • Issue 3

María José Zilleruelo Pozo; Paula Riera Sanz & Gianitsa Georgudis Pinto



Electronic nicotine delivery systems were introduced to replace tobacco use and contribute to the anti-smoking policies. Today, the effect the chemicals it contains produce in the human body, are unknown. The aim of this work was to describe the information found in the literature about the possible damage produced in the periodontal tissue and the oral cavity, by the electronic nicotine delivery systems. An electronic and manual search was carried by a single reviewer, without year or language limit, excluding expert’s opinions and articles that studied other nicotine delivery systems. Eighteen articles were selected; 7 in vitro studies, 2 longitudinal studies, 2 clinical trials and 7 case reports. Toxicity levels were found to be high, showing changes in cellular morphology and metabolism. Comparing with conventional cigarette, toxicity levels were lower in the electronic nicotine delivery systems. Longitudinal studies and clinical trials observed an increase in bleeding on probing and in blood circulation, by using laser doppler velocimetry, when changing from conventional cigarette to electronic cigarette. Also reports about explosions while using these electronic devises were encountered in the literature, with grave consequences in the maxillofacial territory. Electronic nicotine delivery systems show toxic levels, generating necrosis and DNA damage in periodontal ligament and gingival fibroblast cells. The risk of using these devices is high, due to possible explosion following overheating of the lithium battery, causing facial and oral trauma. Clinical trials and longitudinal studies were not conclusive, so investigations should continue in this matter.

KEY WORDS: Electronic Nicotine Delivery Systems, periodontal diseases, mouth.


How to cite this article

ZILLERUELO, P. M. J.; RIERA, S. P. & GEORGUDIS, P. G. Electronic nicotine delivery systems and their effect in periodontal tissue and the orofacial region. A review. Int. J. Odontostomat., 12(3):287-295, 2018.


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