Statement of problem Edentulism in combination with chronic alveolar ridge resorption can lead to a debilitating oral state which conventional complete dentures cannot alleviate. The provision of anterior mandibular implants positively contributes to both function and an improved quality of life for these patients. However, individuals who could most benefit from the treatment are usually older and more likely to have or develop serious health issues. Purpose The purpose of the study was to assess the long-term success of one of the simpler implant treatments available and to consider the impact of a number of factors, including sex, age, health issues, and tobacco habits. This study also assessed the specific implant used, the Calcitek hydroxyapatite coated cylinder. Material and methods Forty-one patients who received 102 implants for mandibular overdenture retention from 1 operator between 1996 and 2002 were included in the study. Measurements were made from a series of radiographs to assess the effect of periimplant bone loss on surviving implants after a period of implant function of between 6 and 10 years. Results The loss of 1 implant lowered the survival rate to 99%. The overall annual bone loss observed was 0.16 mm/year. Individuals with a significant comorbidity exhibited a slight but significant increase in annual bone loss. Conclusions The implant system in this study performed to an acceptable level in a mixed cohort of older individuals, including those with a serious comorbidity or tobacco habit.