The impact of e-cigarette use on periodontal health: a systematic review and meta-analysis.

25 found significant increases in TNF-α among ENDS users, dual users, and cigarette smokers compared to non-smokers, along with elevated IL-1β and reduced IL-1RA, though the latter two did not reach statistical significance.

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We found no evidence for a difference in PPDs between ENDS users and non-smokers/former smokers (MD 0.32, 95% CI −0.27 to 0.92), although there was a slight trend towards higher PPDs in the ENDS group (Fig. 2A ).

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