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

Hanna Adianita; Indra Pribadi; Amaliya

doi:10.47353/ajmpm.v2i2.28

Authors

Hanna Adianita
Indra Mustika Setia Pribadi
Amaliya

DOI:

https://doi.org/10.47353/ajmpm.v2i2.28

Keywords:

combustion-free nicotine delivery system; gingiva; Modified Gingival Index; periodontitis; TNF-alpha.

Abstract

Background: Tobacco smoking is an independent risk factor for periodontitis. Smokers may show impaired inflammatory responses, altered gingival vascular function, and increased salivary tumor necrosis factor-alpha (TNF-alpha). This study evaluated changes in salivary TNF-alpha levels and gingival conditions among smokers who switched from combustible tobacco cigarettes to combustion-free nicotine delivery systems (C-FNDS). Methods: This single-blind, open-label randomized controlled trial with 6-month follow-up was conducted at the Department of Periodontics, Dental and Oral Hospital, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia. Forty smokers were randomized into a C-FNDS switching group and a control group that continued combustible tobacco use. Gingival inflammation was assessed using the Modified Gingival Index (MGI), saliva samples were collected to measure TNF-alpha at baseline, 3 months, and 6 months, and exhaled carbon monoxide (CO) was assessed as a secondary outcome. Results: A total of 40 participants were analyzed. Switching to C-FNDS was associated with a reduction in salivary TNF-alpha levels over 6 months and lower MGI scores compared with continued combustible tobacco smoking. Exhaled CO decreased in the switching group, supporting reduced exposure to combustible tobacco products. Conclusion: Switching from conventional cigarettes to C-FNDS for 6 months was associated with reduced salivary TNF-alpha levels, lower gingival inflammation, and lower exhaled CO levels compared with continued combustible cigarette use.

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Author Biographies

Hanna Adianita

Post-Graduate Student of Periodontology, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia

Indra Mustika Setia Pribadi

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

Amaliya

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

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