Peri-implantitis is a biofilm-mediated inflammatory process that leads to soft- and hard-tissue breakdown. Periimplant diseases are the most frequent biologic implant complication in daily practice. Certain systemic conditions as well as detrimental habits have been demonstrated to negatively impact peri-implant tissue health and stability. In addition, several local predisposing factors were also identified to be associated with the development of periimplantitis, such as the lack of keratinized mucosa, residual cement or a micro-rough implant surface exposed to the oral cavity or the peri-implant sulcus. This clinical review paper will focus on the latter risk factor, which is often caused by poor surgical performance by the clinician during implant surgery. Keywords: Peri-implantitis, peri-implant disease, dental implant, implant infection, risk factor, surgical risk factors