The aim of the present retrospective study was to evaluate clinical and radiological outcomes, in terms of implant survival rate, marginal bone loss, and peri-implantitis incidence, of a titanium implants with an innovative laser-treated surface. Materials and methods: A total of 502 dental implants were inserted in four dental practices (Udine, Arezzo, Frascati, Roma) between 2008 and 2013. All inserted implants had laser-modified surface characterized by a series of 20-μmdiameter holes (7-10 μm deep) every 10 μm (Synthegra®, Geass srl, Italy). The minimum follow-up period was set at 1 year after the final restoration. Radiographs were taken after implant insertion (T0), at time of loading (T1), and during the follow-up period (last recall, T2). Marginal bone loss and peri-implant disease incidence were recorded. Results: A total of 502 implants with a maximum follow-up period of 6 years were monitored. The mean differential between T0 and T2 was 0.05 ± 1.08 mm at the mesial aspect and 0.08 ± 1.11 mm at the distal with a mean follow-up period of 35.76 ± 18.05 months. After being in function for 1 to 6 years, implants reported varying behavior: 8.8% of sites did not show any radiographic changes and 38.5% of sites showed bone resorption. The bone appeared to have been growing coronally in 50.7% of the sites measured. Conclusion: Implants showed a maintenance of marginal bone levels over time, and in many cases, it seems that laser-modified implant surface could promote a bone growth. The low peri-implant disease incidence recorded could be attributed to the laser titanium surface features that seem to prevent bacterial colonization. Future randomized and controlled studies are needed to confirm the results of the present multi-centrical retrospective analysis.