Despite gingival tissue health and scarce plaque accumulation, the profile of inflammatory cytokines in implant crevicular fluid was distinctive of an innate immune response and in higher concentration than in teeth. Other than bacterial stimulus, intrinsic factors related to implants may account for more cytokine production than teeth.

Introduction Localized aggressive periodontal disease is an uncommon finding observed in adolescents and children. Studies have been conducted to elucidate the etiology, contributing factors, and genetic roles in the phenomena. In particular, twin studies have shown genetic makeup to be a substantial risk factor for periodontitis. This case is, to the best of the authors’ knowledge, the first to be presented in literature of a same dwelling, set of monozygotic twins, displaying similar presentation of localized aggressive periodontitis, however with different microbial profiles. Case Presentation A set of 17‐year‐old black male monozygotic twins were referred for a full‐mouth periodontal evaluation and any necessary periodontal treatment on July 7, 2007. A full‐mouth radiographic series, periodontal charting, and intraoral photographs were performed on each individual. A family history was obtained through the biological mother, which yielded no known history of early tooth loss or treatment of severe periodontal disease. The father was not involved in the rearing of the children and his periodontal history was unavailable. An initial and surgical treatment plan was developed. Microbial analysis of subgingival plaque samples was collected on the affected sites. Initial treatment with scaling and root planing, subgingival irrigation, with administration of systemic antibiotics, and oral hygiene instruction, were rendered on both individuals. Conclusion Within limitations of this report, it is demonstrated that different microbial pattern exists on aggressive periodontitis even in genetically identical individuals with the same environmental exposure.