Aim: To evaluate the long-term hard and soft tissue peri-implant tissue stability of bone-level implants using a different implant placement protocol (submerged versus transmucosal). Materials and methods:

Objectives To evaluate radiographic bone level (RxBL) at dental implants and its associated factors in Spain. Material and methods This cross‐sectional study was performed by a network of sentinel dentists from regions of Spain. RxBL was defined as the distance from the implant shoulder to the first clearly visible contact between the implant surface and the bone. Radiographic measurements were performed by two trained and experienced periodontists. Implant and patient data were also collected. Descriptive, bivariate, discriminative and multivariate analyses were done. Results A total of 49 sentinel dentists provided data 275 patients. Mean RxBL from 474 implants (5–13 years) was 1.87 mm (range: 0.00–13.17 mm). Statistically significant associations between RxBL and clinical output variables (bleeding on probing, oedema, plaque, probing depth, suppuration, keratinized tissue) were found. In the multiple regression analysis, statistically significant associations for RxBL were found for smoking habit, implant diameter, years of follow‐up and type of prosthesis (p < 0.01). Conclusions Peri‐implant RxBL ranged from 0 to 13.17 mm. It was significantly associated with clinical output variables and with some potentially predictor variables, at patient‐ (smoking >10 cigarettes/day) and implant‐ (diameter, years of follow‐up, Toronto bridge) levels.