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Impairment of Normal Host Response

1. It is well documented that tobacco smoke and its constituents can prevent neutrophils (PMN) and monocyte-macrophage defensive functions [44-52].

2. In PMN is the first line of defense in the periodontal tissues.

a. The normal passage of PMN from the vessel in periodontal tissues consists of several steps, including capture, rolling, adhesion, and resettlement through the vessel wall, in the connective tissue.

B. Smokers have a minor defect in adhesion and functions compromises blood in the protection of periodontal tissues [53,54].

3. Components of tobacco can also change the production of cytokines and inflammation mediators. Nicotine has the ability to increase the production of interleukin-6 by osteoblasts. Smokers reported that the increased levels of TNF-alpha in crevicular fluid [55].

3. Effect on healing and response to treatment

A. to impair healing in all aspects of periodontal treatment, including nonsurgical treatment, basic periodontal surgery, reconstructive periodontal surgery, mucogingival periodontal plastic surgery and dental implantation [56-65].

B. in non-surgical treatment, Smoking is associated with less depth sensing reduction and less investment gains [57,58,60,63,66-68]. C. tobacco Smoking is a major risk factor for complications associated with the biological oral implants, including peri-implantitis, and the risk increases in time, dose-dependent manner.

1. Some studies have shown that the success of implantation rates decrease in smokers [69-71].

2. Other historical data, however, have not found the Smoking as a variable associated with the implant [72,73]...

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