Perimplant disease diagnosis is as fundamental as it is controversial. Although progress has been made during the last few decades, it’s still hard to find an univocal set of definitions and diagnostic criteria.1-3 The parameters used to define peri-implant disease usually are as follows: Probing Depth (PD), Crestal Bone Loss (CBL), Bleeding on Probing (BOP) and the presence of suppuration and/or fistula.4 Peri-implant mucositis is charac- terised by the inflammation of the soft tissues, detectable by means of BOP, with or without PD deepening, but having no effects on the crestal bone. Conversely, peri-implantitis is characterised by CBL and BOP, alone or in conjunction with PD deepening and pus. Figures 1-3 display the diagnostic steps of a case of peri- implantitis.