Patient with failed implants used estradiol, smoked, and had poor oral hygiene. Which is the highlighted causative factor?

Correct answer: B. Poor oral hygiene

• A. Plausible. Smoking is a major, well-documented risk factor for implant failure (impaired healing, vasoconstriction) — clinically it is often THE leading modifiable cause.
• B. Marked answer. Poor oral hygiene promotes peri-implant mucositis/peri-implantitis and was the item's highlighted choice.
• C. Less likely. Estradiol/estrogen is not a strong independent cause of implant failure compared with smoking or plaque control.

Note: Both smoking and poor oral hygiene are legitimate causes; this recall item highlighted poor oral hygiene.