Peri-implantitis is a plaque-associated pathological condition characterized by inflammation of the peri-implant connective tissues and progressive loss of supporting bone.1 Peri-implantitis is not a rare event,2,3,4 and if not diagnosed and treated may lead to implant loss. After some debate around the etiology of peri-implantitis, it has been well established that this is an infectious disease that share some similarities with periodontitis.5,6 Previous Association studies evaluating the microbiota of healthy and diseased implants7,8,9 and a recent systematic review10 have suggested that established periodontal pathogens, such as Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia are elevated in peri-implantitis in comparison with healthy implants. Despite this evidence, in the literature it is still unclear whether or not there are essential differences between the microbial profile…