Purpose: The aim of the study was to evaluate the biological and technical outcomes of early and delayed placed single tooth implants after 10 years of follow-up. Materials and Methods: Twenty consecutive patients who needed a single tooth replacement in the anterior maxilla were included in this study. Ten implants were placed with an early placement protocol, that is, 4 weeks after tooth extraction, whereas the other 10 implants were placed with a conventional delayed placement protocol, for example, 12 weeks after tooth extraction. At the baseline and at the annual re-examinations, pain from implant regions, mobility, plaque, mucositis, and marginal bone levels were recorded. Biological and technical complications were registered. The patients evaluated the functional and aesthetic outcomes subjectively on a visual analogue scale after 3 and 10 years. Results: All implants were still in situ after 10 years. The cumulative implant survival rate was 100%. Two implant-supported crowns were remade because of ceramic fractures. The 10-year crown survival rate was 90%. No significant differences in implant survival rates were found between the early and delayed protocols, regarding plaque retention, mucositis, or marginal bone levels. After 10 years, the mean marginal bone loss at both sides of the implants was less than 1.0 mm in the two groups. During the 10-year interval, 1 patient lost more than 1.5 mm of marginal bone, 3 patients lost between 1.0 mm and 1.4 mm of bone, and 16 patients lost less than 1.0 mm of bone as an average of the mesial and distal bone loss. Conclusions: This 10-year prospective clinical trial demonstrated a 100% implant survival and a 90% crown survival. The average marginal bone level change was less than 1 mm, and there was no difference between early and delayed implant placement. Patient satisfaction with the implant-supported single crowns reduced with time.