Although the use of hydroxyapatite-coated (HA-coated) endosseous implants in the treatment of dental patients has been established, their clinical predictability remains controversial. This study is an analysis of the clinical predictability and indications for use of HA-coated endosseous implants. This study also discusses the biochemical composition of commercial HA coatings in relation to in vivo predictability, potential concerns, and potential advantages of HA coatings. Clinical studies suggest that HA-coated implants have short-term survival rates (ranging from 6 months to 6 years) that are comparable to short-term survival rates of titanium implants. In addition, clinical data suggest that HA-coated implants may be valuable treatment modalities when placing implants (1) in type IV bone, (2) in fresh extraction sites, (3) in grafted maxillary and/or nasal sinuses, or (4) when using shorter implants (less than or equal to 10 mm). However, long-term controlled studies are required to validate these observations. Keywords: clinical predictability, endosseous implants, hydroxyapatite coatings