Objectives This cross-sectional study primarily aimed at investigating the association between the transmucosal emergence geometry and the prevalence of peri-implant diseases in bone- and tissue-level implants (BL/TL). As secondary objectives, the association of other implant-, prosthesis-, and patient-related variables with crestal bone levels (CBL) and additional radiographic findings was explored.Material And Methods Patients with non-molar single tooth implant-supported prostheses were retrospectively identified for inclusion. Clinical and radiographic examinations were performed cross-sectionally to assess peri-implant diseases (peri-implant mucositis, peri-implantitis), emergence geometry at the transmucosal region (profile type, emergence angles at two levels, and prosthetic platform height), and peri-implant radiographic variables, including CBL. Data were analyzed using multivariate regression.Results A total of 332 implants (166 BL/166 TL) in 266 patients (60 ± 17 years) were evaluated at a mean of 11.2 ± 1.5 years after implant placement. Peri-implant mucositis was significantly influenced by the crown emergence angle (Level 2; OR = 1.03, p = 0.01) and peri-implantitis by implant diameter (OR = 3.82, p < 0.0001). Crown emergence angles > 30° in BL implants and > 48° in TL implants were consistently associated with peri-implant diseases. Mean CBL was 0.54 ± 1.34 mm, with lower values in TL (-0.24 mm; p = 0.036), females (-0.27 mm, p = 0.029), and implants with greater platform height (-0.175 mm/mm, p = 0.01). Peri-implant sheathing was detected in 13.4% of implants, showing no association with implant-related characteristics.Conclusions Wider crown emergence angles were associated with peri-implant diseases, whereas wider implant diameters were associated with increased peri-implantitis prevalence. TL implant design and greater platform height were associated with reduced CBL.
