The purpose of this retrospective long-term study was to evaluate the peri-implant bone changes in immediate implants and matched non-immediate implants as a control group using a specific and proven measurement protocol over a 10-year period, because there are no similar studies published.

One hundred and thirty-three patients received 174 implants (immediate implants (IM) n = 87; control group (CG) n = 87). The two groups were matched following specific criteria for comparison: implant length, diameter, site of the implant, and patient’s gender. For the evaluation, radiographic images were taken, digitalized, and assessed using the “coronal bone defect (CBD)”.

The differences between the means and medians showed a statistically significant difference at the time of insertion, while to the other control dates, no significant differences could be concluded. The median CBD for the control group was 0 mm at the time of insertion and increased to 1.7 mm after 10 years while the CBD for the IM group was 0.7 mm at the time of insertion and increased to 1.5 mm over the 10 years.

Both surgical protocols lead in our study to similar outcomes regarding the loss of bone around dental implants.