Fifty patients underwent single-tooth replacement in the maxillary and mandibular incisor area using two-piece 3.0-mm-diameter implants. Clinical and radiographic measurements of soft and hard tissue levels and esthetic parameters (pink esthetic score/white esthetic score [PES/WES]) were assessed at 3 years. No implant failed (success rate: 100%), and facial soft tissues and marginal bone levels remained stable throughout the study period. The mean total PES/WES was high (14.1 ± 1.75), and only one implant demonstrated an unfavorable esthetic outcome (PES/WES = 10). The use of 3.0-mm-diameter implants appears to be a viable treatment procedure in the medium term for single-tooth anterior restorations with limited dimensions.