The aim of this case-control study was to evaluate the influence of soft tissue thickness at implant placement (thin [ 3 mm] vs thick [≥ 3 mm]) and bone volume (abundant vs limited) on initial crestal bone remodeling of immediate postextraction and delayed (healed site) implants in immediate loading situations. A total of 67 patients with 133 implants could be evaluated, of which 77 were placed immediately after extraction and 56 in healed ridges. If sufficient bone volume is present and primary stability is achieved, immediate loading of the implant yields good clinical and radiographic outcomes, yet implants placed in healed ridges with thin soft tissues are more prone to initial crestal bone loss.