Effect of Vaping on Treatment Outcomes in Patients With Gingivitis, Periodontitis, and/or Peri‐Implant Disease: A Systematic Review

Abstract

ABSTRACT Objective This systematic review aimed to evaluate the effect of vaping on periodontal treatment outcomes for patients with gingivitis, periodontitis, and/or peri‐implant disease. Material and Methods An electronic database search was conducted using Ovid MEDLINE, PubMed, Scopus, and Web of Science, with no date restrictions. An electronic search was conducted through June 30, 2026. Two independent reviewers extracted data according to predefined inclusion criteria and performed screening and quality appraisal. The risk of bias was assessed using the Newcastle‐Ottawa Quality Assessment Scale and the Cochrane Risk of Bias tool. Results Seven studies were included, involving 640 participants: 168 vapers, 138 traditional cigarette smokers, and 334 non‐smokers. There was no significant difference in clinical response to periodontal and peri‐implant therapy between tobacco and e‐cigarette users, both of whom fared worse than non‐smokers. Immunological outcomes were similar between smokers and vapers, with some exceptions, such as higher TNF‐α levels in e‐cigarette users. No meta‐analysis was performed due to the heterogeneity of the included studies. Conclusion Current limited evidence suggests that vaping may be associated with less favorable periodontal and peri‐implant treatment outcomes compared with non‐smoking, with trends resembling those observed in cigarette smokers. Further research is required to clarify the extent to which vaping affects treatment outcomes compared to cigarette smokers.