Purpose: The authors' objective was to measure crestal bone level change in subjects with immediately loaded implants and to identify risk factors associated with changes in bone level. materials and methods: A retrospective cohort study design was used. The sample comprised subjects who had had endosseous implants placed and immediately loaded between July 2001 and July 2003. Demographic, health status-related, anatomic, implant-specific, prosthetic, and surgical variables were examined. The primary outcome variable was change in crestal bone level over time. Appropriate uni-, bi-, and multivariate statistics were computed. Results: The sample comprised 174 subjects who received 347 immediately loaded implants. The mean duration of radiographic follow-up was 6.9 ¡À 4.0 months, respectively. Mean changes in radiographic bone level were -0.5 mm and -0.6 mm on the mesial and distal surfaces, respectively, after a mean of 6.9 months of radiographic follow-up. Using least squares methods, it was estimated that radiographic bone levels would be -1.0 mm and -0.8 mm on the mesial and distal surfaces, respectively, at 12 months. The multivariate model revealed that radiolucency at or adjacent to implant site was associated with an increased risk of crestal bone loss (odds ratio, 1.88; 95% CI, 1.00 to 3.60). Twelve months after placement, 92.5% of implants had had = 1.5 mm of crestal bone loss. Discussion: The results of this study were comparable to the results of other studies comparing immediate loading to delayed loading. Further research to estimate long-term changes in crestal bone loss and to identify risk factors for bone loss with immediate loading is recommended. Conclusion: This study suggests that crestal bone level changes with immediately loaded implants were within the recommended range for 92.5% of the evaluated implants. The mandible showed a higher risk for crestal bone loss compared to the maxilla. Keywords: crestal bone levels, dental implants, immediate loading, multivariate models, retrospective cohort studies, risk factors