Recently published reports(1-5) as well as a consensus statement(6) have suggested an alarming increase in inflammatory responses around dental implants that are accompanied by variable levels of marginal bone loss. These responses are popularly referred to as an escalating disease entity-so-called "peri-implantitis." This emerging mindset poses serious questions for the long-term viability of the osseointegration technique if the condition indeed exists in a primary form. However, the bulk of the existing literature related to osseointegration has not described peri-implant gingivitis with accompanying marginal bone changes in such dramatic terms. In fact, it has been well documented that failure to induce and maintain long-term osseointegration actually occurs in less than 5% of treated patients. Moreover, clinical outcome studies have not routinely described complications related to progressive soft or hard tissue deterioration. Consequently, the current emphasis on the significance of peri-implant bone loss represents either an ignored phenomenon or is an overtly pessimistic interpretation of or emphasis on a somewhat rarely occurring event. In an effort to determine which of these dichotomous occurrences more closely resembles the truth, an independent initiative sought to evaluate questions related to soft and hard tissue damage adjacent to dental implants.