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The aim of this study was to evaluate bone levels with root-analog stepped implants by radiographic analysis over a 10-year period.One hundred fifty-three implants placed in 93 patients were examined after 10-year follow-up. The implant diameters were 3.8 to 6.5 millimeters (mm), whereas the lengths were 10 to 15 millimeters (mm). One hundred seven implants were restored with single crowns or fixed partial dentures, 46 with bar or ball-retained overdentures. Radiographs were taken after surgery, after the insertion of the prosthesis, after 5 and 10 years of loading. Vertical and horizontal bone levels were measured at each control.After 10 years, the mean vertical bone defect (VBD) for all implants was 1.8 mm, whereas the horizontal bone loss was 0.4 millimeters (mm). Implants inserted in the mandibular frontal area lost statistically significant more bone (3.1 ± 1.9 millimeters [mm]) than implants placed in the maxillary frontal area (1.4 ± 1.8 millimeters [mm]; P-value [P] = 0.00). The VBD of implants placed in the mandibular (1.6 ± 2.2 millimeters [mm]) and maxillary posterior region (1.9 ± 2.0 millimeters [mm]) did not show significant differences (P-value [P] = 0.06).The implants showed VBD a moderate range (mean 1.8 mm after 10 years) depending of the implant sites (maxillary frontal area less than mandibular frontal area).