Tissue changes with use
Biologic bases for changes
Tissue changes with abstinence
Paler tissue color
Increased vasoconstriction
Increased blood flow
Decreased bleeding
Oxygen depletion
Initially more bleeding, erythema
Thickened fibrotic consistency, minimal erythema relative to extent of disease
Compromised immune response:
Healthier consistency and anatomy
Fewer and impaired PMNS
Reduced IgG antibody
Gingival recession around anterior sextants
Increased collagenase production
Greater probing depth, bone and attachment loss, furcation invasion
Reduction of bone mineral, impaired fibroblast formation
Stabilization of attachment levels
Refractory status
Impaired wound healing