Smoking is a significant health hazard and contributes to cardiovascular and pulmonary diseases. It can increase postoperative complications during oral and maxillofacial surgery due to its topical effect on the oral mucosa. New alternatives to traditional tobacco products are gaining popularity, in particular, electronic cigarettes. This pilot study investigated the acute effects of nicotine-containing and nicotine-free electronic cigarettes on palatal blood flow (PBF), and compared their effects to traditional cigarettes. 14 medically healthy volunteers (8 males, 6 females, age: 34.7 ± 7.0) were recruited for the study. All patients (N = 14) were requested to smoke nicotine-containing (ECN) and nicotine-free electronic cigarettes (EC0) and a mouthpiece (end of a traditional cigarette) as a control sham smoking blind test (BT). EC users did not smoke a traditional cigarette (TC), resulting in 10 people in the TC group. Palatal blood flow was measured by Laser Speckle Contrast Imager before, immediately after, and 15 min after the exposures. Exhaled carbon monoxide (eCO) and carboxyhemoglobin (COHb) were measured before and immediately after smoking with a piCO+ Smokerlyzer machine. In all groups, no significant differences were observed in the changes of palatal blood flow between time points. Exhaled carbon monoxide and carboxyhemoglobin were significantly higher in the traditional cigarette (TC) group compared to the nicotine-containing electronic cigarette (ECN) and nicotine-free electronic cigarette (EC0) groups, both before and after the exposure (p < 0.05). Acute use of either traditional or electronic cigarettes may have minimal impact on palatal blood flow, but additional studies are required to clarify their impact on the mucosa.

Background/Objectives: Alternative nicotine-containing products have gained popularity in recent years. Our aim is to compare clinical periodontal outcomes following non-surgical periodontal therapy (NSPT) among patients with periodontitis according to nicotine exposure status: cigarette smokers (CS), former smokers (FS), quitters (Q), users of electronic cigarettes (EC), smokeless tobacco users (ST), and non-smokers (NS). Methods: A systematic search of four electronic databases (PubMed, EMBASE, Web of Science, CENTRAL) was performed until January 2025. Sixty-seven studies were included in the qualitative synthesis, of which 56 studies were included in a frequentist network meta-analysis. Two researchers independently collected data on probing pocket depth (PPD), clinical attachment loss, bleeding on probing, plaque index, full mouth plaque score, gingival index, and gingival crevicular fluid volume. Results: NS had significantly higher change in PPD compared with CS (MD: 0.25; CI: 0.13, 0.37; 50 studies; 1359 patients; moderate certainty), EC (MD: 0.98; CI: 0.47, 1.49; 2 studies; 56 patients; very low certainty), and ST (MD: 0.99; CI: 0.49, 1.49; 2 studies; 82 patients; low certainty). Q (MD: 0.02; CI: −0.56, 0.60; 2 studies; 52 patients; low certainty) and FS (MD: 0.03; CI: –0.62, 0.69; 4 studies; 267 patients; low certainty) did not differ significantly from NS. In secondary outcomes, NS, FS, or Q were ranked first. Conclusions: FS and Q showed no statistically significant differences from NS; EC and ST generally had less favorable treatment rankings than CS. The certainty of evidence varied across exposure groups and outcomes. Further studies are needed to support firm clinical recommendations.

Background: Achieving a three-dimensional seal of the root canal system is considered essential for long-term endodontic success. Because no clinically acceptable threshold for void formation has been established, comparisons with clinically validated reference materials are needed to interpret the sealing quality of newer calcium silicate-based sealers (CSBSs). AH Plus is a well-established epoxy resin-based sealer (ERBS) with documented long-term clinical performance. This systematic review and meta-analysis compared the quality of root canal fillings produced with CSBSs and AH Plus using different obturation techniques in permanent mature extracted and artificial teeth. Methods: MEDLINE (PubMed), EMBASE, Cochrane Library, and Web of Science were systematically searched for randomized in vitro studies up to 1 July 2025. The primary outcomes were the percentages of void volume or area. Mean values and mean differences (MDs) with corresponding 95% confidence intervals (CIs) were calculated for the total filling volume and, where available, for the apical, middle, and coronal thirds of the root canal. Risk of bias and certainty of evidence were assessed. Results: Twenty-one studies met the eligibility criteria, and 18 articles were included in the quantitative analysis. No statistically significant differences were observed in total void volume between CSBSs placed with the single-cone technique and AH Plus used with either the single-cone or warm vertical compaction technique in extracted teeth. Similarly, no significant differences were observed between the investigated groups in the apical, middle, or coronal thirds of the root canal. Evidence for other obturation techniques and artificial teeth was limited. Conclusions: Within the limitations of the available in vitro evidence, no statistically significant differences in void formation were detected between the investigated sealer–technique combinations. Further standardized in vitro studies and well-designed clinical investigations are warranted.