Purpose: The appearance of the peri-implant soft tissue is a crucial factor in the success of implant therapy. However, no effective objective method exists to observe and document this factor over the long term. The aim of this clinical trial was to determine whether oral photographs can be used for peri-implant soft tissue data collection by observing peri-implant soft tissue alterations after placement of a single-tooth implant in the esthetic zone and to determine whether the pink esthetic score (PES) reflects patient satisfaction with the peri-implant soft tissue esthetic result. Materials and Methods: Twenty-eight consecutive patients received single implants in the esthetic zone. Clinical photographs were taken to collect data on the peri-implant soft tissue at baseline (crown placement) and again 3 months later. Two observers assigned PES values to the peri-implant soft tissue in the photographs. Changes in the PES value from baseline to the 3-month follow-up were calculated. Patient satisfaction was measured using a visual analog scale (VAS) at the 3-month follow-up appointment. The correlation between the VAS and PES scores was calculated. Results: The mean PES value (± SD) was 8.68 ± 2.69 at baseline and 10.37 ± 2.13 at follow-up (P .01). VAS values ranged from 72.5 to 100. A significant correlation was found between VAS and PES values. The linear regression of patient satisfaction and PES values was significant. Conclusions: Oral photographs can be used to collect PES data on peri-implant soft tissue. The esthetic result of peri-implant soft tissue is markedly improved 3 months after restoration of the implant with a porcelain-fused-to-metal crown. The PES value generally reflects the degree of patient satisfaction with the peri-implant soft tissue esthetic result. Keywords: esthetic zone, oral photograph, patient satisfaction, pink esthetic score, single-tooth implant