The purpose of the present long-term retrospective study was to assess the changing preference of one- vs. two-stage implant placement in partially edentulous individuals. The clinical outcome measures were one- vs. two-stage implant placement, implant survival, and gingival index. The radiological outcome measure was crestal bone loss. Other recorded information included gender, age, implant characteristics (brand, type, length, diameter) and implant location (maxilla/mandible). A total of 393 implants in 111 patients were included. The results revealed that there were no significant demographic differences between the one- and two-stage implant placement groups. There was a preference for one-stage surgery when wide diameter implants were used and when the number of implants per patient was ≤3. The mandible was the major implant site in the one-stage surgery group. Crestal bone loss and gingival index were similar for the two groups in both the short and long term. It can be concluded that lack of any long-term differences in implant survival, crestal bone loss and gingival health around implants after one- or two-stage implant placement promoted a significant change over 18 years, increasing to 50% the prevalence of one-stage surgery