Table 3.
Study designs, characteristics, and results of studies aiming to evaluate the effects of narghile use on periodontal bone height
| First author | Natto (17) | Javed (29) | Present study | ||
|---|---|---|---|---|---|
|
| |||||
| Study design | |||||
| Year of publication | 2005 | 2016 | |||
| Years of the study | NR | 2013–2014 | 2013–2015 | ||
| Town (country) | Jeddah (Saudi Arabia) | Riyadh (Saudi Arabia) | Sousse (Tunisia) | ||
| Study design | Cross-sectional Comparative | Cross-sectional Comparative | Cross-sectional Comparative | ||
| Recruitment method | Announcements/news paper | Visitors of a dental clinic for treatment | Flyers Acquaintances of people involved in the study |
||
| Name of the smoking device | Water pipe | Water pipe | Narghile | ||
| Inclusion criteria | >20 teeth | Healthy individuals Habitual ENS (>1 narghile/day for at least the past year) Habitual ECS (>1 cigarette/day for at least the past year) Non-S |
Male Age: 20–35 years Tabamel smokers |
||
| Non-inclusion (or exclusion) criteria | Pregnancy Unhealthy |
MS Systemic diseases Edentulous individuals Crowded teeth or occlusal trauma Alcohol consumers Tobacco chewers Lactating and/or pregnant females Medication use (antibiotics, non-steroidal anti-inflammatory drugs, steroids) ≤3 months Periodontal treatment ≤6 months |
<20 teeth Tobacco use <5 PY or <5 NY Jurak and/or Tombac smokers Diabetes mellitus, Previous head or neck radiation therapy Medication use: antidepressants. anticonvulsants, cyclosporine A, calcium antagonists |
||
| ENS | Yes | Yes | Yes | ||
| Calculated sample size | No | Yes (no reference cited) | Yes (32) | ||
| Number of ENS (M/F) | 117 (90/27) | 50 (50/0) | 60 (60/0) | ||
| Age of ENS (years) | 17–60a
M: 39 [37–41]b F: 38 [34–43]b |
485±62e years | 20–35a
284±36 [275–294]c |
||
| Starting narghile use age (years) | NR | NR | NR | ||
| Number of years of smoking | NR | 20.5±2.8e | NR | ||
| Type of tobacco | NR | NR | Tabamel | ||
| Method of narghile use quantification | RY | Times/daily Session duration |
NY | ||
| Quantity of narghile tobacco used | 57 [48–66]b RY 44d: <40 RY 56d: ≥40 RY |
Frequency of use: 4.7±1.1e times/daily Session duration: 50.2±6.7e min |
7.1±2.9 [6.3–7.8]e
85d: 5 ≤ NY<10 15d: ≥10 NY |
||
| Grams of tobacco/narghile session | NR | NR | 20 | ||
| Last narghile (h) | NR | NR | NR | ||
| Explorations | Clinical examination [4 sites (buccal, mesial, distal, lingual) for all teeth] Radiographic exam |
Clinical examination [6 sites (mesiobuccal, mid-buccal, distobuccal, distolingual/palatal, mid-lingual/palatal, and mesiolingual/palatal) for all teeth] Radiographic examination |
Clinical examination Radiographic examination |
||
| Questionnaires | Standardized without citing a reference | Non-standardized | Non-standardized | ||
| Used materials | Panoramic digital radiographs | Full mouth digital radiographs | Panoramic digital radiographs | ||
| Comparison with ECS |
n=72 (58 M/14 F) M: 36 [34–38]b years F: 38 [34–43]b years 230 [193–268]b CY 51d: <170 CY 49d: ≥170 CY |
n=50 (50 M/0 F) 50.1±3.5e years Duration of smoking: 22.3±6.5e years Frequency of use: 15.4±3.6e times/daily Session duration: 15.3±0.4e min |
n=60 (60 M/0 F) 27.3±5 [26.1–28.6]c years 70d: 5 ≤ PY <10 30d: ≥10 PY |
||
| Comparison with Non-S |
n=99 (56 M/43 F) M: 38 [35–41]b years F: 35 [32–39]b years |
n=100 (100 M/0 F) 46.5±4.2e years |
NA | ||
| Comparison with MS |
n=67 (51 M/16 F) M: 33 [31–35]b years F: 32 [28–37]b years 174 [141–207]b CY 24 [18–30]b RY |
NA | NA | ||
| Results | |||||
| PBH | BL (%) | BL (mm) | PBH | BL (%) | |
| ENS | 0.76 [0.75–0.78]b†‡ | 27d† | 5.1±0.8e† | 0.86±0.04 [0.84–0.87]c | 12d |
| ECS | 0.76 [0.74– 0.78]b | 24d | 5.6±1.2e | 0.85±0.03 [0.84–0.86]c | 15d |
| MS | 0.80 [0.79–0.82]b | 9d | NA | NA | NA |
| Non-S | 0.81 [0.79– 0.83]b | 6d | 2.2±0.9e | NA | NA |
| Other results | PBH decreases with age. Relative risk of BL (after adjustment for age) associated with narghile use and cigarette smoking compared with Non-S. |
The two groups had similar means of PBH and similar frequencies of BL. | |||
| Conclusions | Narghile use is associated with PBH reduction | The periodontal condition of ENS was equally as poor as ECS. | Both ENS and ECS exhibited the same PBH reduction suggesting that the two types of tobacco smoking are associated with BL. | ||
BL: bone loss. ECS: exclusive cigarette smoker. ENS: exclusive narghile smoker. F: female. M: male. Min: minutes. MS: mixed smoker. NA: not applied. Non-S: non-smoker. NR: not reported. NY: narghile-year. PY: pack-years. RY: run-years.
a
Data are range (minimum and maximum).
b
Data are mean [95% CI].
c
Data are mean±SD [95% CI].
d
Data are percentages.
e
Data are mean±SD. Significant differences
*
ENS versus ECS;
†
ENS versus Non-S;
‡
ENS versus MS.