Osseointegration involves an osseous healing response that may be compromised by aging. This study aimed to test the hypothesis that there is no difference between older and younger adults in osseointegration success. A comparison was made between closely matched groups of 39 older adults who had 190 implants supporting 45 oral prostheses and 43 younger adults who had 184 implants supporting 45 oral prostheses. Patients were monitored for a period of 4 to 16 years after prosthetic loading. At the most recent follow-up, the cumulative implant success was 92.0% for the older group compared to 86.5% for the younger group. No statistical significance could be attributed to the difference in implant survival between the groups throughout the study period. Furthermore, the most common outcome for individual prosthetic sites was 100% implant success, and the original prosthetic design was maintained for as long as each patient was monitored in 41 of 45 prosthetic prescriptions for the older patients, and in 39 of 45 prescriptions for the younger patients. Keywords: age, clinical effectiveness, older adults, oral implants, osseointegration, success