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ced implant survival rate (RR 0.96, 95% CI 0.94-0.98, P less then 0.001) even under regular supportive post-implant treatment. They also showed more radiographic marginal bone loss (WMD 0.34 mm, 95% CI 0.2-0.48, P less then 0.001), pocket depth (WMD 0.47 mm, 95% CI 0.19-0.74, P less then 0.001) and bleeding on probing (WMD 0.08 mm, 95% CI 0.04-0.11, P less then 0.001) when compared to the non-HP group. In implants with a machined surface, again the HP group had more radiographic bone loss (WMD 0.88 mm, 95% CI 0.65-1.11, P less then 0.001