Aim: This study analyzes changes in exposure settings periapical plane on the assessment of dental implants in rabbit tibia by analyzing image quality and osseointegration parameters. Material and methods: A quasi-experimental study was conducted on the tibia bone of rabbits that had been implanted with dental implants for 28 days from the previous research. The sample selection in this study used a purposive sampling technique and obtained a sample of 23 periapical radiographic images of the rabbit tibia bone that had been installed with dental implants for 28 days, with each image having an exposure setting. Data were tested for normality using the Shapiro–Wilk test. Mann–Whitney conducted a qualitative assessment and one-way analysis of variance (ANOVA) and post hoc tests carried out the quantitative evaluation. Results: Assessment results in image quality using the Mann–Whitney U test (0.001 < 0.05) and the results of the osseointegration assessment (relative bone density and fractal dimension) using the one-way ANOVA and post hoc test (0.001 < 0.01). Conclusion: Automatic exposure settings produce better image quality, relative bone density, and fractal dimension than manual exposure settings for osseointegration dental implants. Clinical significance: Differences in assessment of dental implant osseointegration in different periapical radiograph exposure setting groups can be obtained for the best exposure setting to evaluate dental implant osseointegration.