Recent observations suggest that less bone loss may result from placing a more medialized abutment on an implant (platform switching). The objective of this study was to measure the radiographic crestal bone loss and biologic width around conventional and platform-switched implants. Implants were randomly assigned into conventional or switched categories within the same prosthesis. Twenty-five implants were placed and observed in the mandibles of 10 patients for 2 years. A regression analysis demonstrated a significant difference between groups (P ≤ .0001). These findings suggest that less crestal bone loss occurs around a platform-switched dental implant versus a conventional implant. © 2009 by Quintessence Publishing Co Inc.