The purpose of the present prospective randomized study was to evaluate the influence of Laser-Lok microtextured surface on soft tissue peri-implant parameters and esthetics around immediate, functionally loaded implants for single-tooth replacement in the esthetic zone. This study included 77 patients divided into two groups based on different implants used: the control group had BioHorizons tapered internal non-Laser-Lok-type implants (NLL; n = 39) and the test group had BioHorizons tapered internal Laser-Lok-type implants (LL; n = 39). Outcome measures were survival, radiographic marginal bone- level changes, soft tissue parameters, and esthetics. One implant was lost in the test group and one in the control group, for a total survival rate of 96.1% after 3 years. Radiographically, mean crestal bone loss ± standard deviation was 0.59 ± 0.27 mm in the LL group compared with 1.17 ± 0.31 mm in the NLL group. A mean gain in papilla level of 0.41 ± 0.34 mm and 0.17 ± 0.36 mm was observed in the LL and the NLL groups, respectively, while the level of the midfacial peri-implant mucosa remained stable in both groups with no statistically significant differences (0.08 ± 0.42 mm for the LL group vs 0.06 ± 0.36 mm for the NLL group). The mean probing depth values in the LL and NLL groups were 0.58 ± 0.2 mm and 1.89 ± 0.3 mm, respectively. Within the limitations of this study, it was demonstrated that the clinical and esthetic outcome of immediate functional loading was more favorable for LL implants than for NLL implants.