The surface of a dental implant plays a significant role in osseointegration, or the body’s ability to integrate the dental implant into the bony structures of the mouth. The idea is that the rougher the implant surface, the easier it will be for the bone to adhere to it. To improve osseointegration, there are a wide variety of implants available with different types of implant surfaces. Acid etched and sandblasted dental implants are popular choices, however, machined implant surfaces are also used. A machined implant surface simply refers to a manufacturing process that was turned, polished, or milled. While many periodontists believe that etched surfaces have a better osseointegration rate than machined implant surfaces, there are a number of periodontists who use machined implants and have success with them. Patients should discuss with their periodontist about the different types of implant surfaces and which one is recommended.