Purpose: The aim of the review was to compare the long-term clinical success of minimally and moderately rough dental implants in terms of differences in marginal bone loss and survival. Materials and Methods: The pertinent literature was searched by using the PubMed database and requesting major manufacturers to provide reports of their commercially available dental implant systems. Clinical reports meeting the following criteria were reviewed: results of at least 5 years of follow-up, availability of baseline and follow-up radiographs including intraoral radiographs, and availability of marginal bone loss measurements from the baseline to the end of the follow-up period (5 years or more). All the recorded data were analyzed statistically. Results: Seventy-one of 1202 articles met the inclusion criteria. Maxillary moderately rough implants were found to have significantly higher long-term survival rates than maxillary minimally rough implants; no such difference was noticed in the mandible. Significant marginal bone loss occurred around all the implants in the first year but stabilized thereafter, indicating the absence of progressive bone loss. Conclusion: The dental implant systems commercially available today have good long-term clinical success in terms of survival and marginal bone loss.