Implant therapy success in the anterior maxilla is judged not only by osseointegration, but also by having sound and stable peri-implant tissues that appear identical to the gingiva surrounding the healthy adjacent teeth. The creation of predictable peri-implant esthetics requires proper preservation of the osseous and soft tissues surrounding the failing teeth, proper three-dimensional implant placement, and proper understanding of prosthetic management. It is now possible to place immediate implants and immediate prostheses to improve esthetics and to simplify treatment, but this technique does not seem to have a stable long-term buccal mucosa. To avoid or reduce this negative effect it appears to be important to increase the thickness of the buccal tissues, and to use appropriate implant components. The aim of the present retrospective study was to observe the dimensional alterations of the peri-implant tissues after immediate implants and single-tooth restorations with concave abutments performed on 28 patients, with a mean followup time of 20.4 months.