© 2019 by Quintessence Publishing Co Inc. The aim of this randomized, prospective study was to compare clinical and radiographic outcomes of microtextured implants with two different collar designs at 1 year postplacement. A total of 69 implants were assessed in 58 patients for site, patient-specific, and clinician-experience variables. Overall implant survival was 94.9%. A statistically significant preservation of crestal bone was observed in the microgrooved-collar group. Narrow implant diameter was associated with a statistically significant increase in crestal bone loss. Collar design and implant diameter may be important in limiting adverse esthetic and bone loss outcomes during initial function.