Purpose: The aim of this study was to compare the long-term success rates of wide-diameter implants in the mandibular molar region placed immediately after extraction and loaded either immediately or after a 3-month healing period. Materials and Methods: In 71 patients, 120 implants were positioned immediately after tooth extraction; 60 implants (immediate loading group) were loaded immediately and 60 were loaded after 3 months (delayed loading group). Radiographic examinations were made at baseline and at 1, 2, 3, 4, and 5 years after implant placement. Results: After 5 years, a survival rate of 96.67% was reported for all implants (failure rate, 3.33%). Four implants were lost, two from the immediate loading group and two from the delayed loading group. There were no patient dropouts in either group. Conclusions: Wide-diameter implants placed in fresh extraction sockets and loaded immediately or after a delay showed no significant clinical or radiographic differences after 5 years. Keywords: extraction sockets, immediate loading, wide-diameter dental implants