Purpose: This study evaluated the status of teeth adjacent to single-tooth implants in the anterior and posterior jaw during a follow-up of more than 3 years. Materials and Methods: Seventy-eight single-tooth implants and 148 adjacent teeth were followed for a mean of 58 months. Implant survival rate, peri-implant structures, and prosthetic complication rates were evaluated. Crowns and periodontal status of adjacent teeth were compared at crown placement and at the last examination. Horizontal distance from the implant edge to adjacent teeth was calculated and compared for anterior and posterior regions. The influence of approximal crestal bone resorption of the adjacent teeth was calculated using multivariate regression analysis. Results: The clinical findings for implants (one loss), periimplant structures, and prosthetic complication rates (three crown fractures) were excellent. There was a high proportion of intact adjacent teeth in both anterior and posterior regions at crown placement and at the follow-up examination. No adjacent teeth required extraction or endodontic treatment, and only four required restoration. Comparison of the periodontal status at crown placement and at follow-up revealed no differences for plaque and bleeding indices or for pocket depth of adjacent teeth. There was a significant influence of the horizontal distance on approximal bone loss in the closer distance of the anterior region, but not in the posterior region. Conclusion: The crown and periodontal status of teeth adjacent to single-implant restorations was excellent. The approximal bone crest reduction of the adjacent teeth was significantly influenced by the horizontal distance between the implant edge and neighboring tooth.