Purpose: Immediate loading has become an emerging technique because it has been shown to be a successful, time-saving procedure. Recently, immediate loading has been performed simultaneously with implant placement into fresh extraction sockets; excellent results have been achieved, but few reports are available with a long-term follow-up. The aim of the present study was to evaluate the difference in success rates in the maxilla between postextraction implants and implants placed in healed sites, both of which were immediately loaded, after a long-term follow-up. Materials and Methods: Between October 2001 and February 2003, 239 implants were inserted in 81 consecutively operated patients and immediately loaded; 138 implants were placed in fresh postextraction sites (57.7%) and 101 implants were placed in healed sites (42.3%). Two different implant systems were used in this study. Each implant was loaded within 72 hours of placement (60.3% at the time of surgery, 6.3% after 24 hours, 30.1% after 48 hours, and 3.3% after 72 hours). Preestablished success criteria were used to evaluate the success rate of the implants. Results: The mean follow-up was 6.7 years (range: 6.0 to 7.3 years). Only 8 of the 239 implants failed, for an overall success rate of 96.6%. Six of the failed implants were inserted in postextraction sites, and 2 had been placed in healed sites; the success rates were 95.7% and 98.0%, respectively. Statistical analysis revealed no significant differences between postextraction and healed sites. Conclusions: Immediate loading of immediate postextraction sites results in an implant success rate that is broadly comparable to that seen for implants placed in healed sites. Moreover, this procedure can provide predictable and favorable results in many different clinical conditions and for a long term. Keywords: dental implants, healed sites, immediate loading, long-term follow-up, maxillary implants, postextraction sites