Purpose: The aim of this study was to evaluate and compare crestal bone changes in response to loaded and unloaded titanium implant with hydroxylapatite coated surface. Materials and Methods: The study was conducted on 8 male patients with 8 missing maxillary premolar teeth. Their age ranging from 30-50 years. The patients were divided into 2 groups: Group1; included 4 patients who underwent immediate insertion of titanium implant in the period ranging from 1 – 3 months post extraction followed by immediate non functional loading of restoration within 1 week after the surgery, Group2; included 4 patients who similarly underwent immediate insertion of titanium implant in the period ranging from 1 – 3 months post extraction with delayed loading. Results: The clinical and radiographic analysis revealed that there was no significant difference in crestal bone height between the two groups. However, the loaded group showed significantly lower rate of crestal bone loss than the delayed loaded group through all periods. Conclusions: Immediate loaded implants decrease crestal bone loss around dental implants and enhance bone formation.