〔Abstract〕 ObjectiveTo investigate the relationship between the transgingival characteristics of implant restorations and peri-implant soft tissue with peri-implant mucositis and peri-implantitis using three-dimensional measurement techniques. MethodsA total of 121 bone-level implant restorations in posterior tooth positions from 73 patients were evaluated using three-dimensional data analysis software, based on clinical and radiographic examination data. The following characteristics were assessed: emergence angles, including the mucosal emergence angle (MEA), deep angle (DA), and total angle (TA); emergence profile; and peri-implant soft tissue. Generalized estimating equations were used to analyze the relationship between these characteristics and the occurrence of peri-implant mucositis and peri-implantitis. Results TA and MEA showed significant statistical relevance to peri-implant mucositis. Implant restorations with a TA greater than 30° had a 1.7 times higher risk of developing peri-implantitis compared to those with a TA of less than 30°. ConclusionMEA and TA of bone-level implant restorations in posterior tooth positions are significantly correlated with peri-implant mucositis. An excessive TA increases the likelihood of peri-implantitis. It is recommended that both the coronal and overall emergence angles of implant restorations should not exceed 30°.