AIM: The purpose of this prospective cohort study was to assess the survival and success rates of palatal implants. MATERIAL AND METHODS: Seventy patients (56 female, 14 male; age 25-6 +/- 10-8 years) receiving Orthosystem (Straumann AG, Basel, Switzerland) palatal implants from March 1999 to November 2006 were included. The indication was established according to the required anchorage for orthodontic therapy. All implants were placed in a mid-sagittal, median or paramedian palatal location by the same surgeon. They were orthodontically loaded after a healing period of 8-16 weeks (Mean: 12.8 weeks). RESULTS AND DISCUSSION: Of the initially 70 consecutively admitted patients, two implants in two patients were not primary stable after installation and had to be removed. Of the 70 initially installed palatal implants, 67 implants or 95.7% osseointegrated successfully and were loaded actively and/or passively for approximately 19 months. Only one implant of the 67 osseointegrated implants lost its stability under orthodontic loading. By the time of re-evaluation, 20 palatal implants were still used for orthodontic therapy, while 46 implants had been removed after completed orthodontic therapy. By only analyzing those, the success rate of the initially installed implants was 92%. CONCLUSIONS: Orthodontic palatal implants with a rough surface are predictable and highly reliable devices for a multitude of maxillary orthodontic treatment options. The survival and success rates for palatal orthodontic implants are comparable to dental implants installed for dental prostheses.