ObjectivesTo compare smokers to non-smokers in terms of soft tissue alterations following single implant treatment in healed bone. Material and methodsNon-smoking and smoking patients with sufficient bone volume in need of a single implant in the anterior maxilla (15-25) were consecutively recruited in three centres. Conventional single implant surgery was performed and an immediate provisional crown was installed. Eight to 12weeks later, the latter was replaced by a permanent one (baseline). Papilla regrowth and midfacial recession was registered after 2years of function. ResultsThe sample consisted of 39 non-smokers (21 females; mean age 42) and 46 smokers (22 females; mean age 45). Smokers had three early failures, whereas all implants integrated successfully in non-smokers. Statistically significant papilla regrowth was observed in non-smokers (distal 0.63mm, mesial 0.76mm), whereas smokers showed stable papillae (between cohorts: P0.025). Midfacial soft tissue level demonstrated statistically significant regrowth in non-smokers (0.53mm), whereas it remained stable in smokers (between cohorts: P=0.004). ConclusionSmokers failed to demonstrate papilla regeneration and showed more midfacial recession following single implant treatment when compared to non-smokers.