Purpose: The aim of this study was to evaluate the behavior of hard and soft tissue around implants with different surface treatments. Materials and Methods: Eight patients were identified for this study. Each patient received at least 2 implants (1 control, 1 test) into an edentulous quadrant, for a total of 10 pairs of implants. Two types of implants were used: hybrid implants (control) with a dual acid-etched surface in their apical portion and a machined coronal part, and test implants with an acidetched surface throughout their entire length. Standardized periapical radiographs were taken at baseline, 3 months, 6 months, and 1 year post implant placement and then annually until the 6-year follow-up. Bleeding on probing (BOP) and Plaque Index (PI) were recorded annually. Probing depth (PD) was recorded at the 6-year follow-up. Results: Moderate crestal bone remodeling was observed during the 1-year postimplant placement evaluation (P = .001), and test implants revealed smaller marginal bone resorption (P = .030). No significant changes in bone level were observed between the 1-year and the 6-year follow-up appointments, and a significantly smaller bone resorption was found at test implants. No statistically significant differences in bone resorption were found between maxilla and mandible. No statistically significant differences were detected between test and control implants for BOP, PI, or PD. Conclusions: The preliminary results suggest that implant surface characteristics might affect the bone remodeling phase subsequent to the surgical trauma. However, once osseointegration was established, implant surfaces did not affect bone maintenance over time. Implant surfaces did not affect soft tissue behavior. The results of this pilot study need to be confirmed in a study with a larger sample size and over a longer time frame.