Objectives <p>This study examined the impact of maximum tongue strength (MTS) on implant stability, peri-implant bone density, and marginal bone loss (MBL) in the posterior mandible.</p> Materials and methods <p>Thirty patients (14 males, 16 females) received a total of 37 dental implants in the posterior mandible to support fixed single crowns. MTS was measured anteriorly and posteriorly, then pooled mean used for analysis. Implant stability was measured in implant stability quotient (ISQ) and peri-implant bone density was assessed using cone-beam computed tomography (CBCT) at 3 months post-surgery. Meanwhile the 1-year MBL was evaluated using periapical radiographs. Additionally, age, gender, body mass index (BMI) and implant characteristics were recorded.</p> Results <p>All implants remained functional at 1 year, with a 100% survival rate. The mean MTS was 56.4 ± 10.1&#xa0;kPa. MTS correlated positively with increased implant stability at 3 months post implant placement (r_s=0.38, <i>p</i> = 0.02). Regression analysis showed that age (<i>p</i> = 0.02) and gender <i>(p</i> = 0.04) were significant predictors of ISQ, while MTS was not an independent predictor. General linear model analysis revealed that MTS interacted significantly with age (<i>p</i> = 0.04) and gender (<i>p</i> = 0.002), indicating that both factors modulated the relationship between MTS and early implant stability. No significant associations were observed between MTS and peri-implant bone density or 1-year MBL.</p> Conclusion <p>MTS was associated with greater implant stability at 3 months in posterior mandibular implants. As this was a cohort study, no causal inference can be drawn.</p> Clinical relevance <p>Measuring MTS may help clinicians identify patients at higher risk of reduced implant stability, supporting personalized risk assessment and treatment planning.</p>