Purpose: The aim of this study was to investigate the influence of interimplant distance of internal connection implants with platform switching on crestal bone loss using radiographic evaluation. Materials and Methods: The present study included patients missing two consecutive teeth in the posterior quadrant and receiving internal connection implants. Digital periapical radiographs were taken at the time of superstructure connection and at the time of more than 1 year of loading. Bone level change was measured on the modified image using a digital subtraction program. The crestal bone loss between implants and the horizontal and vertical loss of peri-implant marginal bone were evaluated, and the influence of interimplant distance on crestal bone loss was analyzed at α = .05. Results: A total of 10 pairs of implants having ≤ 3 mm of interimplant distance was included in this study (group 1). The other 15 pairs of implants having > 3 mm of interimplant distance were selected as a control group (group 2). After the mean 19.3 months of observation, the mean crestal bone loss between implants was -0.26 ± 0.14 mm in group 1 and -0.23 ± 0.29 mm in group 2 (P > .05). There was no significant difference between the interimplant distance and the crestal bone loss according to the regression analysis (P = .765). The mean horizontal and vertical marginal bone loss was -0.18 ± 0.25 mm and -0.15 ± 0.18 mm, respectively, in group 1 and -0.17 ± 0.31 mm and -0.11 ± 0.33 mm, respectively, in group 2. There were no significant differences between outside and inside bone loss of implants in horizontal and vertical change (P > .05). Conclusions: Within the limitations of the shortterm study, the interimplant distance did not affect the crestal bone loss with internal connection implants with platform switching. The horizontal and vertical marginal bone loss was found to be too small to result in overlapping loss of the interimplant crestal bone. Keywords: crestal bone loss, digital subtraction, internal connection, interimplant distance, platform switching, tissue thickness