The replacement of teeth in fully partially edentulous patients with dental implants has become an acceptable standard of care. The improved efficacy and success of dental implants has been the result of rigid adherence to the prerequisites for osseointegration. This direct bone-to-implant contact has been described histologically and the success or failure of dental implants may depend upon the relative percentage of this contact. Connective tissue and epithelial interactions with implant surfaces have also been characterized, however, to a lesser degree. Connective tissue morphology was shown to be dependent upon the type of implant surface, i.e. smooth versus porous. The epithelial interactions with implants seems to be similar to those around teeth. The formation of a peri-implant sulcus lined coronally with a sulcular epithelium and more apically with a junctional epithelium has been demonstrated. A better understanding of the interactions between the implant surfaces and the surrounding tissues may enhance treatment results.