ANN ARBOR, Mich., US: As the number of dental implants placed globally continues to rise, so too does the clinical significance of understanding peri-implant disease. Although the role of bacterial biofilms in peri-implant disease is well established, the initial microbial processes that influence the development of the peri-implant environment are still not fully understood. Shedding light on the issue, new research suggests that bacteria trapped within the implant’s connection under the cover screw during placement may play a foundational role in shaping the peri-implant microbiome and determining future clinical outcomes.