Purpose: The gradual shift from using implants with turned surfaces to implants with moderately rough surfaces has raised questions regarding the long-term behavior of the latter. The aim of the present retrospective study was to compare clinical and radiographic data of the two implant surfaces using the "same mouth" approach. Materials and Methods: A total of 122 consecutive patients were treated with both turned and TiUnite implants; however, 26 of these patients could not be reached for follow-up and were excluded from the study. The remaining 96 patients received 257 turned and 243 TiUnite Brånemark System implants, not necessarily supporting the same constructions and not necessarily inserted during the same session. Data were collected up to 10 years of function. Results: During the first 6-year period, 18 turned implants and 1 TiUnite implant failed, resulting in implant cumulative survival rates (CSRs) of 93.0% and 99.1% for turned and TiUnite implants, respectively. During the following years, 1 turned and 3 TiUnite implants failed, resulting in CSRs of 90.3% and 96.6% for the two surfaces, respectively, a significant difference. A small but significant difference in mean bone level was seen between turned and TiUnite implants. Conclusion: Implants with turned and TiUnite surfaces showed comparable clinical and radiographic data during the study period. The early implant failure rate, as well as the overall failure rate, were significantly reduced when using TiUnite implants.