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中华口腔医学研究杂志(电子版) ›› 2024, Vol. 18 ›› Issue (02) : 137 -142. doi: 10.3877/cma.j.issn.1674-1366.2024.02.010

综述

新型烟草制品与传统卷烟对口腔常见疾病的影响研究进展
梁坤1, 曾梓涵2, 谢力1, 于珂2, 钟欣楠2, 陈业娴1, 刘锴1, 黄睿洁2,()   
  1. 1. 四川省新型烟草制品工程技术研究中心,成都 610101;四川三联新材料有限公司,成都 610101
    2. 口腔疾病防治全国重点实验室,国家口腔医学中心,国家口腔疾病临床医学研究中心,四川大学华西口腔医院儿童口腔科,成都 610041
  • 收稿日期:2023-12-17 出版日期:2024-04-01
  • 通信作者: 黄睿洁

The impact of new tobacco products and traditional cigarettes on common oral diseases

Kun Liang1, Zihan Zeng2, Li Xie1, Ke Yu2, Xinnan Zhong2, Yexian Chen1, Kai Liu1, Ruijie Huang2,()   

  1. 1. New Tobacco Products Engineering and Technology Research Center of Sichuan Province, Chengdu 610101, China; Sichuan Sanlian New Material Company Limited, Chengdu 610101, China
    2. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2023-12-17 Published:2024-04-01
  • Corresponding author: Ruijie Huang
  • Supported by:
    National Natural Science Foundation of China(31800114); Sichuan Sanlian New Material Company Limited Science and Technology Innovation Project(KJSB202010230007)
引用本文:

梁坤, 曾梓涵, 谢力, 于珂, 钟欣楠, 陈业娴, 刘锴, 黄睿洁. 新型烟草制品与传统卷烟对口腔常见疾病的影响研究进展[J]. 中华口腔医学研究杂志(电子版), 2024, 18(02): 137-142.

Kun Liang, Zihan Zeng, Li Xie, Ke Yu, Xinnan Zhong, Yexian Chen, Kai Liu, Ruijie Huang. The impact of new tobacco products and traditional cigarettes on common oral diseases[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2024, 18(02): 137-142.

新型烟草制品逐步走进大众的视野,同时也在青少年之间愈来愈流行。新型烟草制品主要分为电子烟和加热卷烟。由于新型烟草制品相对于传统卷烟减少了部分有害燃烧产物,它的使用通常被认为和推广为吸烟者更安全的替代品,甚至是协助吸烟者戒烟的产品之一。然而,低毒不代表无毒;与此同时,使用电子烟的人群对传统卷烟接受度高于不吸烟人群。因此,在此综述新型烟草制品和传统卷烟的异同,阐明新型烟草制品与龋病、牙周病和口腔癌等口腔常见疾病的关系。由于加热卷烟相关报道较少,本文主要以电子烟的相关报道为主。龋病方面,虽然相比于传统卷烟,电子烟吸烟者龋风险较小,但电子烟的使用者比从未吸过烟的人群更有可能患有未经治疗的龋齿。牙周病方面,电子烟和加热卷烟均可引起牙周菌群的改变、引发牙龈上皮细胞的炎性反应而加重牙周组织的炎症。口腔癌方面,细胞学实验表明电子烟对口腔癌有一定促进作用,电子烟可一定程度上引起口干症,但其作用较传统卷烟较弱。在使用时,电子烟也会因爆炸而造成吸烟者的牙外伤及颌面部损伤。综上所述,新型烟草制品亦会引发口腔疾病,虽然其作用较传统卷烟小,但由于电子烟问世较短,尚缺乏长期前瞻性和大规模病例对照研究数据,需要更长期的研究来充分了解新型烟草制品对口腔健康的影响。

New types of cigarette products have gradually entered the public attention and become increasingly popular among teenagers. The new types of cigarette products usually refer to electronic cigarettes (e-cigarettes) and heat-not-burn tobacco (HNB) . Because there are less harmful combustion products in the new types of cigarette products than the combusted cigarettes, the use of new types of cigarette products is often considered as a safer alternative to smoking, and even as one of the products to assist smokers to quit smoking. However, low toxicity does not mean non-toxic. The use of e-cigarettes may make people more prone to use cigarettes. Therefore, we reviewed the similarities and differences between e-cigarettes, HNB and combusted cigarettes, and clarified the relationship between new types of cigarette products and common oral diseases such as dental caries, periodontal diseases, and oral cancers. Since the reports of heat-not-burn tobacco are limited, this review would focus mainly on e-cigarettes. In terms of dental caries, e-cigarette users were more likely to have untreated dental caries than non-smokers, but e-cigarette smokers were less likely to have caries than combusted cigarette smokers. In terms of periodontal diseases, both e-cigarettes and heat-not-burn tobacco can cause changes in periodontal flora, trigger an inflammatory response in gingival epithelial cells, and aggravate the inflammation of periodontal tissue. In terms of oral cancers, in vitro experiments have shown that e-cigarettes have a certain promoting effect on oral cancer. E-cigarettes can cause dry mouth to a certain extent, but their effects are less than those of combusted cigarettes. Upon usage, e-cigarettes can also cause dental trauma and maxillofacial injuries to smokers due to e-cigarettes explosions. In summary, new types of cigarette products can promote oral diseases, although their effects are less than those of combusted cigarettes. However, due to the short history of e-cigarettes, there is still a lack of long-term prospective and large-scale case-control study. Longer-term research is needed to fully understand the impact of new types of cigarette products on oral health.

表1 电子烟、加热卷烟与传统卷烟制品的比较
鉴别点 电子烟 加热卷烟 传统卷烟
结构和工作原理 电子烟的基本组成部分包括气溶胶发生器、流量传感器、电池和含尼古丁溶液的储存区。通过电加热和气雾化的方式使电子烟内由尼古丁、香味物质等组成的液体转化为类似于卷烟烟雾的气溶胶混合物[1] 加热卷烟主要由加热装置和烟草构成,加热装置将烟草加热到足够高的温度以产生含尼古丁的气雾剂,但温度较低,烟草不会燃烧[10] 卷烟纸将烟丝卷制成条状的烟制品,通过燃烧产生烟雾,从而被使用者吸入。
加热温度 145 ~ 334 ℃(常规状态下)[11] 350 ℃ 最高可达800 ~ 900 ℃
尼古丁[12] 电子液体尼古丁含量为0 ~ 100 mg/mL。尼古丁输送可以与传统香烟相近,但因装置设计(如:加热温度)、电子液体尼古丁含量和用户行为而异。 传送量与传统香烟类似。 烟杆中的平均值,13.5 mg(范围:11.9 ~ 14.5 mg);吸烟者的吸入量:1.0 ~ 1.5 mg/支。
有害物质(除尼古丁外) 以羰基和芳香族化合物以及胺为主,其产率比可燃卷烟的产率低1 ~ 2个数量级。 羰基和芳香族化合物以及胺的含量与电子烟的相对相似。此外,亚硝胺是在烟草烘烤过程中而不是在燃烧过程中产生的,可以转移至气溶胶中,但含量总体也低于传统卷烟,而高于电子烟[4] 香烟烟雾中含有大约7 000种不同的化合物,其中至少有70种被证实或怀疑是人类致癌物,包括砷、苯、甲醛、铅、亚硝胺和钋[5]
细胞毒性[4]
炎症反应[4]
[1]
Sapru SVardhan MLi Q,et al. E-cigarettes use in the United States:Reasons for use,perceptions,and effects on health[J]. BMC Public Health202020(1):1518. DOI:10.1186/s12889-020-09572-x.
[2]
Cooper MPark-Lee ERen C,et al. Notes from the field:E-cigarette use among middle and high school students—United states,2022[J]. MMWR Morb Mortal Wkly Rep202271(40):1283-1285. DOI:10.15585/mmwr.mm7140a3.
[3]
Chaffee BWHalpern-Felsher BCheng J. E-cigarette,cannabis and combustible tobacco use:Associations with xerostomia among California adolescents[J]. Community Dent Oral Epidemiol202351(2):180-186. DOI:10.1111/cdoe.12721.
[4]
Goniewicz M. IBS11.01 Electronic cigarettes and heat-not-burn tobacco products — How are they different[J]. J Thorac Oncol201914(10 Suppl):S101. DOI:10.1016/j.jtho.2019.08.221.
[5]
Prochaska JJBenowitz NL. Current advances in research in treatment and recovery:Nicotine addiction[J]. Sci Adv20195(10):eaay9763. DOI:10.1126/sciadv.aay9763.
[6]
Chaffee BWCouch ETVora MV,et al. Oral and periodontal implications of tobacco and nicotine products[J]. Periodontol 2000202187(1):241-253. DOI:10.1111/prd.12395.
[7]
Aldakheel FMAlduraywish SAJhugroo P,et al. Quantification of pathogenic bacteria in the subgingival oral biofilm samples collected from cigarette-smokers,individuals using electronic nicotine delivery systems and non-smokers with and without periodontitis[J]. Arch Oral Biol2020117:104793. DOI:10.1016/j.archoralbio.2020.104793.
[8]
Zhong JCao SGong W,et al. Electronic cigarettes use and intention to cigarette smoking among never-smoking adolescents and young adults:A meta-analysis[J]. Int J Environ Res Public Health201613(5):465. DOI:10.3390/ijerph13050465.
[9]
Rouabhia M. Impact of electronic cigarettes on oral health:A review[J]. J Can Dent Assoc202086:k7.
[10]
Vora MVChaffee BW. Tobacco-use patterns and self-reported oral health outcomes:A cross-sectional assessment of the Population Assessment of Tobacco and Health study,2013-2014[J]. J Am Dent Assoc2019150(5):332-344.e332. DOI:10.1016/j.adaj.2018.12.004.
[11]
Yang ISandeep SRodriguez J. The oral health impact of electronic cigarette use:A systematic review[J]. Crit Rev Toxicol202050(2):97-127. DOI:10.1080/10408444.2020.1713726.
[12]
Rouabhia MSemlali A. Electronic cigarette vapor increases Streptococcus mutans growth,adhesion,biofilm formation,and expression of the biofilm-associated genes[J]. Oral Dis202127(3):639-647. DOI:10.1111/odi.13564.
[13]
Cunningham AMcAdam KThissen J,et al. The evolving e-cigarette:Comparative chemical analyses of e-cigarette vapor and cigarette smoke[J]. Front Toxicol20202:586674. DOI:10.3389/ftox.2020.586674.
[14]
Cheng T. Chemical evaluation of electronic cigarettes[J]. Tob Control201423(Suppl 2):ii11-ii17. DOI:10.1136/tobaccocontrol-2013-051482.
[15]
Vemulapalli AMandapati SRKotha A,et al. Association between vaping and untreated caries:A cross-sectional study of National Health and Nutrition Examination Survey 2017-2018 data[J]. J Am Dent Assoc2021152(9):720-729. DOI:10.1016/j.adaj.2021.04.014.
[16]
Irusa KFFinkelman MMagnuson B,et al. A comparison of the caries risk between patients who use vapes or electronic cigarettes and those who do not:A cross-sectional study[J]. J Am Dent Assoc2022153(12):1179-1183. DOI:10.1016/j.adaj.2022.09.013.
[17]
Catala-Valentin ABernard JNCaldwell M,et al. E-Cigarette aerosol exposure favors the growth and colonization of oral Streptococcus mutans compared to commensal Streptococci[J]. Microbiol Spectr202210(2):e0242121. DOI:10.1128/spectrum.02421-21.
[18]
Kim SASmith SBeauchamp C,et al. Cariogenic potential of sweet flavors in electronic-cigarette liquids[J]. PLoS One201813(9):e0203717. DOI:10.1371/journal.pone.0203717.
[19]
Jeong WChoi DWKim YK,et al. Associations of electronic and conventional cigarette use with periodontal disease in South Korean adults[J]. J Periodontol202091(1):55-64. DOI:10.1002/jper.19-0060.
[20]
Akram ZAati SAlrahlah A,et al. Longitudinal evaluation of clinical,spectral and tissue degradation biomarkers in progression of periodontitis among cigarette and electronic cigarette smokers[J]. J Dent2021109:103678. DOI:10.1016/j.jdent.2021.103678.
[21]
Figueredo CAAbdelhay NFigueredo CM,et al. The impact of vaping on periodontitis:A systematic review[J]. Clin Exp Dent Res20217(3):376-384. DOI:10.1002/cre2.360.
[22]
ALHarthi SBinShabaib MAkram Z,et al. Impact of cigarette smoking and vaping on the outcome of full-mouth ultrasonic scaling among patients with gingival inflammation:A prospective study[J]. Clin Oral Investig201923(6):2751-2758. DOI:10.1007/s00784-018-2725-2.
[23]
Alhumaidan AAAl-Aali KAVohra F,et al. Comparison of whole salivary cortisol and interleukin 1-beta levels in light cigarette-smokers and users of electronic nicotine delivery systems before and after non-surgical periodontal therapy[J]. Int J Environ Res Public Health202219(18):11290. DOI:10.3390/ijerph191811290.
[24]
Park BKoh HPatatanian M,et al. The mediating roles of the oral microbiome in saliva and subgingival sites between e-cigarette smoking and gingival inflammation[J]. BMC Microbiol202323(1):35. DOI:10.1186/s12866-023-02779-z.
[25]
Xu FPushalkar SLin Z,et al. Electronic cigarette use enriches periodontal pathogens[J]. Mol Oral Microbiol202237(2):63-76. DOI:10.1111/omi.12361.
[26]
Karaaslan FDikilitaş AYiğit U. The effects of vaping electronic cigarettes on periodontitis[J]. Aust Dent J202065(2):143-149. DOI:10.1111/adj.12747.
[27]
Beklen AUckan D. Electronic cigarette liquid substances propylene glycol and vegetable glycerin induce an inflammatory response in gingival epithelial cells[J]. Hum Exp Toxicol202140(1):25-34. DOI:10.1177/0960327120943934.
[28]
Sundar IKJaved FRomanos GE,et al. E-cigarettes and flavorings induce inflammatory and pro-senescence responses in oral epithelial cells and periodontal fibroblasts[J]. Oncotarget20167(47):77196-77204. DOI:10.18632/oncotarget.12857.
[29]
D′Ambrosio FPisano MAmato A,et al. Periodontal and peri-implant health status in traditional vs. heat-not-burn tobacco and electronic cigarettes smokers:A systematic review[J]. Dent J (Basel)202210(6):103. DOI:10.3390/dj10060103.
[30]
Pagano SNegri PConiglio M,et al. Heat-not-burn tobacco (IQOS),oral fibroblasts and keratinocytes:Cytotoxicity,morphological analysis,apoptosis and cellular cycle. An in vitro study[J]. J Periodontal Res202156(5):917-928. DOI:10.1111/jre.12888.
[31]
Flach SManiam PManickavasagam J. E-cigarettes and head and neck cancers:A systematic review of the current literature[J]. Clin Otolaryngol201944(5):749-756. DOI:10.1111/coa.13384.
[32]
Yu VRahimy MKorrapati A,et al. Electronic cigarettes induce DNA strand breaks and cell death independently of nicotine in cell lines[J]. Oral Oncol201652:58-65. DOI:10.1016/j.oraloncology.2015.10.018.
[33]
Ganapathy VManyanga JBrame L,et al. Electronic cigarette aerosols suppress cellular antioxidant defenses and induce significant oxidative DNA damage[J]. PLoS One201712(5):e0177780. DOI:10.1371/journal.pone.0177780.
[34]
de Lima JMMacedo CCSBarbosa GV,et al. E-liquid alters oral epithelial cell function to promote epithelial to mesenchymal transition and invasiveness in preclinical oral squamous cell carcinoma[J]. Sci Rep202313(1):3330. DOI:10.1038/s41598-023-30016-0.
[35]
Manyanga JGanapathy VBouharati C,et al. Electronic cigarette aerosols alter the expression of cisplatin transporters and increase drug resistance in oral cancer cells[J]. Sci Rep202111(1):1821. DOI:10.1038/s41598-021-81148-0.
[36]
Rogér JMAbayon MElad S,et al. Oral trauma and tooth avulsion following explosion of e-cigarette[J]. J Oral Maxillofac Surg201674(6):1181-1185. DOI:10.1016/j.joms.2015.12.017.
[37]
Harrison RHicklin D Jr. Electronic cigarette explosions involving the oral cavity[J]. J Am Dent Assoc2016147(11):891-896. DOI:10.1016/j.adaj.2016.03.018.
[38]
Tran VMian MSreedharan S,et al. Oral and maxillofacial injuries associated with e-cigarette explosions:A systematic review and management guidelines proposal[J]. J Oral Maxillofac Surg202381(5):583-592. DOI:10.1016/j.joms.2023.01.009.
[39]
Holliday RChaffee BWJakubovics NS,et al. Electronic cigarettes and oral health[J]. J Dent Res2021100(9):906-913. DOI:10.1177/00220345211002116.
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