Purpose: To evaluate and compare the difference in retention between implant-supported restorations with and without surface modification of the implant abutments. Materials and Methods: A total of 30 patients with singletooth implants were restored with cement-retained (Multilink N, Ivoclar) restorations using titanium base abutments (Variobase, Straumann) and randomly assigned surface modifications. Group 1 used nonmodified abutments, group 2 used sandblasted abutments, and group 3 used sandblasted abutments followed by an application of metal primer. All patients were recalled for a baseline examination 6 months after crown placement. The pull-out strength and intergroup distribution of mean pull-out strength were assessed. To assess differences between the three groups, intergroup statistical comparison of continuous variables was done using one-way ANOVA with Tukey correction for multiple group comparisons. Results: The results of the intergroup mean pull-out strength distribution revealed that the distribution of mean ± SD pull-out strength in group 1, group 2, and group 3 were 220.79 ± 94.23, 488.64 ± 84.12, and 705.46 ± 112.75 Ncm, respectively. Conclusions: Sandblasting followed by the application of metal primer produced the highest retention of porcelain-fused-to-metal (PFM) crowns to titanium base abutments, followed by sandblasting alone, with the least retention being observed with no surface treatment.