Dental implants are intended to provide long-term reliable dental restorations. Limited data exist on the comparison between different implant surfaces. This study aims to clarify whether there is a difference between airborne particle– abraded and acid-etched (SLA implants) and only acid-etched surfaces (Osseotite) in healthy and periodontally compromised patients. After comprehensive evaluation of all 109 patients, including nonsurgical and surgical therapy for the treatment of periodontal disease, 109 implants were placed according to the manufacturer's guidelines. Each treatment site was examined radiographically 3 to 6 months after the final coronal restorations were placed. Patients were enrolled in the follow-up maintenance program, and radiologic evaluations were carried out at 5 and 10 years. Data recorded from 91 patients who completed the final 10-year follow-up were included in the analysis (SLA: n = 50; Osseotite: n = 41). At 10 years, the difference between bone-to-implant distances (DIBs) for SLA and Osseotite was significantly different (P = .001; 95% confidence interval: 0.55, 1.89 mm). Mean ± SD DIB for SLA implants was 2.1 ± 1.1 mm and 0.9 ± 2.1 mm for Osseotite implants. The overall survival rates of SLA and Osseotite implant surfaces were high during the observation period. History of previous periodontal disease plays an important role in the incidence of complications, regardless of the surface type.