Between 1994 and 1999, 515 Astra standard implants were placed and documented prospectively in 107 patients. Of these implants, 364 were placed in original jawbone, 38 in areas augmented with local osteoplasty, and 113 in bone grafts from the iliac crest. The main indications for implantation were an atrophic edentulous alveolar crest (n = 361) and a shortened dental arch (n = 113). Single-tooth implants were excluded. In a special clinical examination, 56 patients with 258 implants were investigated. The average in situ time of the implants was 34.2 months. Failing osseointegration (n = 10), peri-implantitis (n = 10), and implant fracture (n = 1) in 15 patients resulted in the failure of 21 implants (4.1%). Three patients with 8 implants died from malignant tumor. Currently, 27 implants have been lost to follow-up, and 488 implants remain in situ (95.9%). Under analyses with different implant success criteria, the success rate decreased to 85%. Based on the results in this patient population, this implant was found to be a useful alternative to established implant systems for the indications analyzed. Keywords: dental implant, implant failure, marginal bone resorption, osseointegration, peri-implantitis