Radiographs were taken and evaluated by the same examiner that placed the implants (DF). For each case the real implant length served as the calibration value to derive the Distance from Implant shoulder to the first Bone to implant contact (DIB). CBL was defined as DIB minus the neck length (NL) of an implant with the following standardization values to account for different implant neck designs designs: 2.8 mm for standard tissue level, 1.8 mm for standard plus tissue level and tapered effect, and 0 mm for bone level implants (see supplementary Figure 1 in online Journal of Periodontology). The CBL was a single score recorded as the greatest value from either the mesial or distal measurement as determined by examiner at each recall. Marginal bone loss (MBL) was defined as the change in CBL between subsequent time points during follow‐up, using stage 2, i.e.: 3 months post‐installation, as the baseline.

The risk indicators evaluated in relationship to MBL included 1) pre‐existing disease including autoimmune, diabetes types 1 and 2 and history of periodontitis, 2) heavy smoking (>15 cigarettes/day) and 3) bisphosphonate use, 4) implant location, 5) diameter, 6) implant design, 7) immediate loading, 8) bone defect (=GBR), and 9) insertion torque.

Peri‐implant soft tissue was evaluated by probing with a light vertical probe force of 17 g using a calibrated force automated probe or manual probe calibrated to about 17 g at six locations around the implant (mb, b, db, ml, l, dl) m = mesial, b = buccal, d = distal, l = lingual. The soft tissue condition based on probing was determined using the Implant Mucosal Index (IMI) which is a modification of the SBi whereby 0 = no bleeding, 1 = minimal single‐point bleeding, 2 = moderate multi‐point bleeding, 3 = profuse multi‐point bleeding, and 4 = suppuration.