Purpose: The use of the roll pedicle flap has been recommended by various authors, but there are no studies evaluating the stability of the augmented soft tissue in the long term. The aim of this retrospective study was to evaluate the stability of peri-implant soft tissue augmented with the roll flap technique in patients with congenitally missing maxillary lateral incisors after 10 years of function. Materials and Methods: Patients with congenitally missing maxillary lateral incisors restored with dental implants in the period between 2000 and 2002 were invited for reexamination after 10 years. The esthetic of the peri-implant soft tissue was evaluated with Furhauser's pink esthetic score (PES). Results: The peri-implant soft tissue of 21 implants in 17 patients was evaluated at the 10-year follow-up. No implants were lost within the duration. The PES score was slightly improved from 11.43 ± 1.504 at baseline to 11.70 ± 1.793 at the 10-year follow-up examination without a statistically significant difference (P > .05). Conclusion: Within the limitations of this study, the roll flap technique was found to be a sustainable method for the achievement of durable peri-implant esthetics in the anterior maxillary region, especially in terms of variables related to tissue contour and appearance. Keywords: dental agenesis, dental implants, long-term results, pink esthetic score