The anterior maxilla represents a therapeutic challenge for single-tooth replacement with implants. The surgical trauma delivered to soft and hard tissues during implant placement can influence the future esthetic result. The clinician should use surgical techniques that prevent esthetic complications, such as increased crown length or loss of interdental papillae, without compromising osseointegration. This prospective study investigated the interproximal crestal bone loss occurring after placement of single-tooth implants using 2 different flap designs: a widely mobilized flap design that included papillae, and a limited flap design that protected papillae. The interproximal crestal bone loss was of practical importance and statistically significantly less following the use of a limited flap design versus the widely mobilized flap procedure. Keywords: alveolar bone loss, comparative study, dental papillae, implant-supported dental prosthesis, preprosthetic oral surgical procedures, single-tooth dental implants, surgical flaps