Purpose: Controversy over the long-term clinical effectiveness of hydroxyapatite (HA) -coated dental implants still persists, despite numerous clinical studies documenting high survival rates. The Ohio State University College of Dentistry undertook a 5-year prospective study of 429 HA-coated cylindric implants placed into 121 patients to determine the long-term clinical performance of the implants. Materials and Methods: All study subjects were patients screened and evaluated in the university's dental clinic by one of the principal investigators and one member of the surgical team. A total of 429 HA-coated implants were placed in 121 patients. The Ohio State University Human Subjects Committee approved and reviewed this study. Results: At the time of this report, 375 implants had completed 5 years of clinical follow-up. Beyond the 5-year limit of the study, 282 implants had completed 6 years and 114 implants had completed 7 years of clinical monitoring. The cumulative survival rate was 96% at 5 years and 95% at 7 years of follow-up. Mean combined mesial/distal bone loss was 1.2 mm in the mandible and 1.4 mm in the maxilla after 5 years of functional loading. Implant failures were most commonly associated with short implants or angled abutments. Discussion: Prospective clinical data are extremely valuable for clinicians evaluating the reliability of dental implant systems. In the present study, the implants achieved 100% osseointegration with minimal marginal bone loss, and 96% of the implants remained in function at 5 years. Conclusion: The HA-coated cylindric implants in this study provided a predictable means of oral rehabilitation.