Background: The immediate loading of implants with a porous anodized surface is a well-described technique. Few data are however available on the long-term outcomes.

Purpose: The aim of this prospective study was to assess the 10-year performance of TiUnite implants supporting fixed prostheses placed with an immediate loading approach in both postextractive and healed sites.

Materials and methods: All patients received a fixed provisional restoration supported by immediately loaded parallel design, self-tapping implants with a porous anodized TiUnite surface, and an external-hexagonal connection. Both healed and postextractive cases were included. Success and survival rate for restorations and implants, changes in marginal peri-implant bone level, probing depth measurements, biological or technical complications, and any other adverse event were recorded at yearly follow-up up to 10 years after surgery.

Results: A total of 210 implants fulfilled the inclusion criteria and were consecutively placed in 59 patients. Forty-seven (22.38%) implants were lost because of the recalled patient refused to attend the planned 10-year follow-up. Five over 210 (2.38%) implants were lost. At the final follow-up, the accumulated mean marginal bone loss and probing depth were, respectively, 1.93 mm (SD 0.40) and 2.54 mm (SD 0.44) for the implants placed in healed sites (n = 84); 1.98 mm (SD 0.37) and 2.63 mm (SD 0.39) for the implants placed in postextractive sites (n = 74). The restorations examined achieved a cumulative 65.26% success rate and 97.96% survival rate. The implants placed in healed and postextractive sites, respectively, achieved a 98.05% and a 96.52% cumulative survival rate.

Conclusions: Positive results in terms of bone maintenance in the long-term perspective are to be expected using immediately loaded implants with a TiUnite porous anodized surface in both postextractive and healed sites when adequate levels of oral hygiene are kept.