Dental Implant Healing With TNF-Alpha Inhibitors

Inclusion Criteria: * Over the age of 18 * Require placement of implants to assist with dental restoration. * Half of the patients (15) will be recruited with the key criteria of a TNF-alpha inhibitor medication that they have been taking consistently without dose adjustment or other changes for at least 6 months. The other half will be recruited without a target medical condition but will be recruited to match the patients taking TNF-alpha inhibitors in age and gender. * All patients will be medically fit to withstand implant placement as judged by best practice applied by the study team. * The patients will be required to read and speak English * All patients must either provide their own independent consent for medical procedures or to attend study visits with a surrogate decision maker. Exclusion Criteria: Patients will not be excluded on the basis of age (within the adult population), race, economic status, sex or gender, or other demographic factors. Patients will be excluded if: * They have periodontal disease (periodontal pockets above 4mm in the applicable arch or radiographic evidence of horizontal bone loss more than mild severity) * There is other evidence of pathology in the treated arch on pre-treatment review including radiographs, such as any evidence of cyst or tumor formation in the mandible. * They have uncontrolled diabetes (HbA1c \>8.0) as confirmed by evaluating labs taken on anyone with diagnosed diabetes in the 6 months before the study enrollme…