Evidence map›Paper›PMID 40247359›Full record

ArticleSystematic reviews2025

Oral health effects of non-combustible nicotine products: protocol for a systematic review and network meta-analysis.

Giusy Rita Maria La Rosa, Cinzia Del Giovane, Eugenio Pedullà, Jan Kowalski, Iain Chapple, Silvia Minozzi, Amaliya Amaliya, Riccardo Polosa

Abstract read
In one paragraph

Article in Systematic reviews, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Giusy Rita Maria La RosaDepartment of Clinical and Experimental Medicine, University of Catania, Catania, Italy. giusy.larosa@unict.it.ORCID 0000-0001-5127-5299
Cinzia Del GiovaneDepartment of Medical and Surgical Sciences for Children and Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy.
Eugenio PedullàDepartment of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
Jan KowalskiDepartment of Periodontology, Medical University of Warsaw, Warsaw, Poland.
Iain ChapplePeriodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK.
Silvia MinozziDepartment of Epidemiology, Lazio Regional Health Service, Rome, Italy.
Amaliya AmaliyaDepartment of Periodontology, Faculty of Dentistry, Universitas Padjadjaran, West Java, Indonesia.
Riccardo PolosaDepartment of Clinical and Experimental Medicine, University of Catania, Catania, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTobacco use is a global issue, and non-combustible nicotine products (NCNPs) like electronic nicotine delivery systems, nicotine pouches, snus, and nicotine replacement therapies offer potential risk/harm reduction for smokers unable or unwilling to quit. Although NCNPs are less harmful than tobacco smoking, their impact on oral health remains unclear. A systematic review and network meta-analysis will be conducted to answer the research question: What are the oral signs and symptoms associated with NCNPs as both monotherapies and combination therapies compared to each other, placebo, standard care, no drug treatment, and combustible cigarette smoking?

methodsWe will search PubMed and Scopus databases, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to August 2024. This review will focus on randomized controlled trials (RCTs) with a minimum follow-up period of 1 month, comparing any NCNPs versus placebo, standard care, no drug treatment, combustible cigarette smoking or to each other in adult smokers. Our primary outcomes will be the number of participants reporting any oral side effect, aphthous ulcers, dry mouth and mouth irritation. Studies will be excluded if they involve: non-smokers, pregnant women, individuals with mental health or neurological disorders, participants consuming alcohol or other substances. Data will be analyzed using a network meta-analysis framework, estimating odds ratios with 95% confidence intervals. Risk of bias will be determined using the Cochrane risk of bias tool-version 2.0 for included RCTs and the Confidence In Network Meta-Analysis tool will be employed to assess the confidence of evidence contributing to each network estimate. DISCUSSION: Our findings will provide critical insights into the oral health implications of NCNPs, informing clinical and public health decisions. Results are expected by May 2025 and will be disseminated through publications and presentations to guide tobacco harm reduction strategies. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42024565118.

Indexed as

Electronic Nicotine Delivery SystemsOral HealthTobacco ProductsTobacco Use Cessation DevicesHumansNetwork Meta-Analysis as TopicResearch DesignSmoking CessationSystematic Reviews as TopicElectronic nicotine delivery systemsNetwork meta-analysisNicotine replacement therapyNon-combustible nicotine productsOral healthOral side effect

Identifiers

PMID40247359
PMCPMC12004883

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.