Objective: The goal of this observational study was to evaluate the occurrence, incidence rate, and esthetic impact of facial growth in adult patients subjected to rehabilitation with single implants on the anterior maxillary region (pre-maxilla), specifically in the central incisors, to evaluate the influence of time on changes in the incisal level. Methods: Patients who received single implants in #11 or #21 (A.D.A. #8 or #9), with age greater than nineteen years old on the date they received the implant and with the presence of adjacent teeth, were included. As exclusion criteria: implants with less than five years of installation, implants adjacent to dental elements that have undergone some anatomical change in the incisal area due to restorations, fractures, or excessive wear; rehabilitation with implants in both central upper incisors. Standardized pictures were obtained to evaluate the presence and incidence of incisal linear changes. All rehabilitation followed the same standard of reconstruction and received the same incisal level of the homologous and adjacent tooth in order to mimicry and achieve the best esthetic for the patient. Thus, in T0, the incisal level difference between the crown and the adjacent tooth was zero; any modification in the incisal levels, from 1.0 mm of difference, was registered. It was considered 1.0 mm as the cutoff mark because this number permits easy observation of any difference, either by professional or patient. The data obtained were analyzed and correlated statistically. Results: A total of 56 patients/implants were included (aged between 23 and 63; an average of 40.79 ± 12.25); incisal level alteration between teeth and implants was found, leading to an incidence rate of 19.6% of patients. The study had an average follow-up of 10.7 ± 3.37 years. All implants evaluated had stability and healthy peri-implant tissue condition throughout the follow-up, with a 100% survival rate. There was no statistically significant prevalence of incisal level changes between males (19%) and females (20%) (p=0.238); there was an incidence of 41.7% in the group between 20 and 30 years old, 13.3% between 30 and 40 years old, 23.7% between 40 and 50 years old, and 6.3% in the group over 50 years old was found, but with no statistically significant differences (p=0.118) among different age groups. Similarly, no statistically significant difference was observed (p=0.262) comparing the number of clinical cases in each subgroup with and without change in the incisal level. Conclusion: It was possible to conclude that the changes in the incisal level in maxillary anterior crowns retained by single implants in the adult patient were presented in 19.6% of the cases evaluated. This prevalence was not influenced by gender or age group; however, it was observed more often in dental implant cases with longer follow-ups.