Tissue integration of one-stage, nonsubmerged ITI implants over a 5-year period is documented. Fifty-four implants were placed in 38 partially edentulous patients. No implants had detectable mobility after a healing phase of at least 3 months, and there were no clinical signs of peri-implant infection. Radiogaphs revealed no peri-implant radiolucencies and all implants were in favorable positions for fixed prosthetic restorations. Following completion of the prosthetic treatment, all patients were placed in 3-month oral hygiene recall programs. Annual dental examinations included evaluation of each implant according to fixed criteria. Three years after implant placement, 51 of 53 implants (96.2%) were evaluated as successful (one patient was lost to the study). Acute peri-implant infections were associated with two implants; both were classified as late failures. The results demonstrated that one-stage transgingivally healing ITI implants integrate dependably in the tissue and that successful tissue integration can be maintained for at least 3 years.