A bone-splitting technique used for anterior single-tooth replacement was evaluated in 54 patients and 68 sites. The cumulative rate of implant survival was 93.7% (SE 4.5%) after more than 4 years. The decrease in marginal bone height ranged from 0.8 to 1.3 mm. Some reaction of the bone levels around the adjacent teeth should be anticipated (.03 to 0.5 mm). It was concluded that the bone-splitting procedure is a safe and predictable technique when performed carefully on selected patients and with the proper instrumentation. The procedure seeks to reconstruct the labial contour of the alveolar process, which is a prerequisite for optimal and lasting implant esthetics.