Introduction: Dental implants have lately emerged as a viable therapeutic option for replacing missing teeth. Implants have undergone continuous improvement to increase their functionality and longevity to meet patients' needs for shorter treatment periods and the need to deal with increasingly complex clinical situations. Surface modifications have been the focus of continuous improvement in modern implants, guiding a new era of surface treatment with chemically modified hydrophilic surfaces. Objectives: To evaluate the effect of different surface treatments of dental implants on osseointegration in the mandibular posterior area. Methodology: This randomized controlled clinical trial was conducted on twelve patients with missing mandibular posterior teeth randomly allocated into two groups. Group I: six patients received hydrophilic dental implants, while Group II: six patients received conventional sandblasted acid etched dental implants. Implant stability, bone density, marginal bone loss, and biochemical analysis of bone formation using Runt-related transcription factor 2 (RUNX2), were all assessed for the two groups. Results: There were no significant differences between the two groups concerning implant stability (P=0.381), bone density around the implants (P=0.326), marginal bone loss around the implants (P=0.416), or biomarkers of bone formation (RUNX2) (P=0.828) along the course of the clinical trial. Conclusion: The Acqua group outperformed the conventional group in all clinical parameters, although the difference was not statistically significant.