Changes in Microbial Status From Dentate, Edentulous and After Dental Implant Placement

Inclusion Criteria: 1. At least 21 years of age 2. Diagnosis of Stage III or IV periodontitis based on full mouth probing and full mouth x-rays 3. Planned for full mouth extraction and replacement by dental implants. 4. Rehabilitation with Implant supported restorations either maxilla and/ or mandible. 5. At least 2 implants available for examination. 6. No bone augmentation required. Exclusion Criteria: 1. Conditions requiring chronic routine prophylactic use of antibiotics. 2. Conditions requiring prolonged use of steroids. 3. History of leukocyte dysfunction and deficiencies 4. Bleeding disorders 5. History of neoplastic disease requiring use of radiation or chemotherapy 6. Metabolic bone disorders 7. Uncontrolled endocrine disorder 8. Use of any investigational drug or device within the 30 day period prior to implant surgery. 10\. Alcoholism or drug abuse 11. Patient infected with HIV 12. Condition or circumstances, in the opinion of the investigator, which would prevent completion of study participation or interfere with analysis of study results, such as history of non-compliance, unreliability. Local Exclusion Criteria 1. Local inflammation 2. Mucosal disease such as erosive lichen planus 3. History of local irradiation therapy 4. Osseous lesion. 5. Active infection with suppuration or fistula track. 6. Persistent intraoral infection different than periodontitis