Due to lack of long-term data (> 5 years), the heterogeneity and variability in study designs and lack of reporting on confounding factors, definitive conclusions on differences in implant survival, and mean marginal bone loss between machined and moderate rough implants in periodontally compromised patients cannot be drawn. In order to understand whether or not machined surfaces are superior to moderately rough surfaces in patients with a history of periodontal disease, well-designed long-term randomized controlled trials are needed.