Purpose The study aims to evaluate the long-term clinical outcome of immediate loading of implants in the edentulous mandible. Materials and Methods Patients were treated at least 1 year prior to evaluation, with four to five implants and an immediate provisional bridge in the edentulous mandible. They were invited for a clinical examination, which included the removal of the bridge, probing, perio-testing, clinical photographs, and a new radiograph to determine the bone level. Also, patients were requested to answer the OHIP-14 questionnaire to rate their satisfaction with the treatment Results Forty-six patients (21 men, 25 women), mean age 60 years (SD 8.5, range 43-77), were treated with 211 implants. One implant failed to integrate, resulting in a survival rate of 99.5%. After a mean follow-up of 90 months (SD 45, range 17-143), the mean bone level was 1.17mm (SD 0.49, range 0.36-4.88). The mean Periotest value was -5.48 (SD 0.883, range -2 to -7). The mean probing depth was 2.04mm (SD 0.71, range 1.00-8.25). There were 83.3% of the implants that demonstrated no bleeding at probing. Calculus was observed at 13.9% of the abutments. Around one implant (0.5%), suppuration was seen after probing. There was a highly significant correlation between bone loss and probing depth (p<.001). Overall, patients were very satisfied, with 69.6% scoring their treatment as excellent Conclusion Immediate loading of surface-enhanced implants is a highly predictable and successful treatment modality in the edentulous mandible.