PURPOSE: Tapered implants are thought to result in equivalent long-term stability and marginal peri-implant bone height in comparison to cylindrical implants. The goal of this study was to compare the primary stability and osseointegration of a novel bone-level tapered-wall implant to a control bone-level cylindrical implant with exactly the same surface characteristics, in a direct side-by-side comparison in an animal model. MATERIALS AND METHODS: Mandibular premolars and first molars were extracted in 11 G.ttingen minipigs, and healing was allowed for 3 months. Six implants were placed with a 4-week surgical lag time between hemimandibles (three per side), and either immediately loaded (first implantation time point) or submerged (second implantation time point). Eight-mm-long × 4.1-mm-diameter titanium screw-type bone-level implants with tapered (two per side) and cylindrical bodies (one per side) were used (Institut Straumann); insertion torque and implant stability were measured, and the soft tissue was closed. Standardized radiographs were taken at implant placement and at sacrifice. Following a healing period of 1 month from the last surgical intervention (8 weeks total healing time for loaded implants; 4 weeks total healing time for nonloaded implants), the animals were sacrificed and mandibular blocks were harvested for nondecalcified histologic and histomorphometric analysis. RESULTS: All implants were integrated radiographically and osseointegrated histologically. Maximum insertion torque measurements and implant stability quotient values showed no significant difference between tapered and cylindrical implants. Histomorphometric analysis also resulted in comparable bone-to-implant contact values between the implant types and similarly limited marginal peri-implant bone resorption; no significant differences were observed regarding all the evaluated parameters between the groups, regardless of the loading regime. CONCLUSION: In a direct side-by-side comparison, in an intraoral minipig model, a novel bone-level tapered screw implant with an SLActive surface showed comparable clinical and histologic outcomes to a parallel-walled bone-level screw implant with an SLActive surface.