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High grade examples are tough to come by for this reason

However, less is known about these risk factors in African Americans who are disproportionately affected. Participants self-reported their cigarette smoking status through a questionnaire at baseline

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Components of the smoke, particularly nicotine and carbon monoxide, interfere with the metabolism and function of critical resident cells, most notably gingival fibroblasts and periodontal ligament cells, which are responsible for producing and maintaining the collagen fibers that anchor the tooth to the bone

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