Peri-implant disease is currently an area of clinical concern and focus. The presentations are extremely variable, as are the etiologies. In the current issue, Drs Sarmiento, Norton, and Fiorellini present a classification system for peri-implant diseases and conditions that segregates the various etiologies into pathologic and nonpathologic. The system identifies the majority of bone loss as associated with biofilm, followed by iatrogenic factors, exogenous irritants, absence of keratinized tissue, and extrinsic pathology. Enhanced classification will lead to advanced levels of diagnosis and identification of preventive and therapeutic approaches to improve patient care.