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Nicotine impairs healing: Beyond the physical act of smoking, nicotine itself reduces blood flow to the extraction site, slowing down the natural healing process and increasing infection risk

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[15] investigated the histopathologic features of OSF, observing mucosal changes such as atrophic changes, pigment incontinence, ulceration with granulation tissue, hyperplastic changes, dysplasia, and carcinoma at rates of 74.3%, 62.8%, 40%, 25.7%, 8.6%, and 0%, respectively