Effects of Switching from Conventional Cigarettes to Combustion-Free Nicotine Delivery Systems (C-FNDS) on Salivary TNF-α Levels and Gingival Conditions, A Randomized Controlled Trial

Hanna Adianita; Indra Mustika Setia Pribadi; Amaliya Amaliya

Authors

Hanna Adianita Universitas Padjadjaran, Bandung, Indonesia Author
Indra Mustika Setia Pribadi Universitas Padjadjaran, Bandung, Indonesia Author
Amaliya Amaliya Universitas Padjadjaran, Bandung, Indonesia Author

Keywords:

Smokers, Tobacco Cigarettes, Combustion Free Nicotine Delivery Systems, C-FNDS, TNF-α, Modified Gingival Index, MGI, Gingiva, Periodontal Disease

Abstract

Introduction: Tobacco smoking is an independent risk factor for periodontitis. Studies indicated that periodontal deterioration is more pronounced in active smokers than in non- smokers and former smokers. Inflammation response in smokers is impaired as well as gingival blood vessel functions. Smokers demonstrated elevated salivary TNF-α levels but reduced clinical signs of inflammation. The present study evaluated changes in salivary TNF-α levels and gingival conditions in smokers who switched to Combustion- Free Nicotine Delivery Systems. Material and Methods: Forty smokers were randomly allocated to an experimental and a control group. The experimental group had to switch to Combustion-Free Nicotine Delivery Systems for six months, while the control group did not change their smoking habits. Inflammation in the gingiva was assessed using Modified Gingival Index (MGI) scores, and saliva was collected on day 0, day 90, and day 180 to evaluate TNF-α levels. An unpaired T-test was employed, with a p-value <0.05 considered significant. Results: This study demonstrated that switching from tobacco smoking to C-FNDS for 6 months resulted in a statistically significant decrease in salivary TNF-α levels (p < 0.05). The mean MGI was greater in the smoking group than in the switching group. This indicates a correlation between TNF-α levels and the degree of inflammation. The switching group exhibited a reduction in TNF-α levels, and clinically, the gingival inflammation was less severe than that of the control group.

Conclusion: Switching from smoking to C-FNDS resulted in reduced salivary TNF-α levels and diminished gingival inflammation during 6 months.

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Author Biographies

Hanna Adianita, Universitas Padjadjaran, Bandung, Indonesia

Post-Graduate Student of Periodontology, Faculty of Dentistry
Indra Mustika Setia Pribadi, Universitas Padjadjaran, Bandung, Indonesia

Department of Periodontology, Faculty of Dentistry
Amaliya Amaliya, Universitas Padjadjaran, Bandung, Indonesia

Department of Periodontology, Faculty of Dentistry

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