PURPOSE: The aim of this study was to evaluate and compare the outcomes of immediately loaded all-ceramic crown restorations supported by implants placed in both mature bone and immediate extraction sockets. MATERIALS AND METHODS: Forty-three tapered, external hex implants were placed immediately after extraction or in healed bone in a convenience sample of 38 patients from two clinics, with 23 implants immediately placed after tooth extraction and 20 placed in mature bone. Thirty implants were located in the maxilla and 13 in the mandible. Each surgical implant placement was followed by the fabrication of a screw-retained all-ceramic crown (zirconia-toughened alumina cylinder and layered with porcelain) that was then put into immediate function. Each patient was recalled annually for clinical and radiographic assessments. RESULTS: All implants were loaded immediately and all functioned successfully following a mean follow-up of 26 months. Significantly more bone loss was recorded around delayed implants compared with immediately placed ones. Smoking, platform switching, and jaw location did not influence peri-implant bone loss. Porcelain chipping was noted in the case of two crowns. CONCLUSION: The short-term outcome of prefabricated ceramic cylinders used to support a single screw-retained crown was regarded as successful. Immediate implant placement did not appear to increase the risk for implant failure and was accompanied by reduced peri-implant bone loss.