The goal of this clinical trial is to learn how different materials used in dental implants affect the surrounding gum tissue in adults who need dental implants. The main questions it aims to answer are:

How do different materials (titanium, PEEK, zirconia, and lithium disilicate) affect inflammation around dental implants? What changes occur in inflammation markers in the gum tissue after 3 and 6 months? Researchers will compare the different materials to see which one causes the least amount of inflammation.

Participants will:

Receive dental implants made from different materials. Have samples of fluid from around their implants collected for analysis at 3 and 6 months.

Undergo regular dental check-ups to measure gum health, such as bleeding and pocket depth around the implants.

The study will involve a total of 40 edentulous patients, each missing four teeth in the posterior region of the mandible or maxillae. Each patient will receive four dental implants and single crowns made from different materials. The primary objectives are to evaluate biomarkers in peri-implant crevicular fluid and to assess the changes in these biomarkers after three and six months of loading. This research will help determine the biocompatibility of the materials and their potential to cause peri-implantitis.

Inclusion Criteria:

• Participants must be 18 years or older.
• Participants must be edentulous with at least four missing teeth in the posterior region of the mandible or maxillae.
• Participants must have appropriate oral hygiene and periodontal status of natural teeth, with a pocket depth of 4mm or less and no bleeding.
• Dental implants must be fully integrated with no bone resorption or inflammation after three months of implant placement, confirmed by X-ray and clinical examination.
• Implant placement must be into natural bone without additional procedures such as sinus lift or bone augmentation.
• The procedure must be a standard implantation with no immediate implant placement.
• The height of the gingiva must be at least 3mm or more.

Exclusion Criteria:

• Patients with systemic diseases such as malignancy, diabetes, osteoporosis, or rheumatoid arthritis.
• Patients with a history of periodontal treatment.
• Patients who smoke or use tobacco.
• Patients who have received antibiotic treatment within three months prior to implantation.
• Pregnant individuals.

Individual participant data (IPD) will be made available to other researchers upon reasonable request. The data will include de-identified participant data, relevant clinical and biochemical measurements, and any other pertinent data collected during the study.

Data will be available after the primary and secondary outcomes have been published, and will remain accessible for five years following the end of the study.

Researchers can request access to the IPD by contacting the principal investigator. Requests should include a research proposal and a data use agreement.