Background: Gingival esthetics around dental implants have become a main focus for clinicians. This study analyzed the surgical, prosthetic, and anatomic factors involved in the management of peri-implant tissues. Methods: Forty-eight subjects with one tooth scheduled for tooth extraction and immediate implant placement were included in the study. After healing, the implants were restored with single-crown fixed prostheses. The following parameters were assessed after 12 months: presence/absence of the interproximal papilla, interimplant–tooth distance (ITD), distance from the base of the contact point to the interdental bone (CPB), and soft tissue biotype. ITD and CPB values were derived from computer analysis of periapical radiographs. A statistical analysis determined the effect of ITD and CPB on the presence of the interproximal papilla. Results: Papilla was significantly present (P <0.05) for ITD of 2.5 to 4 mm in anterior and posterior areas and for CPB ≤7 mm in posterior areas. Thick biotype was significantly associated (P <0.05) with the presence of the papilla. Conclusions: The combination of surgical and prosthetic plans represents the key factor to optimize predictability in single-implant esthetics. The recommended interproximal distance between the implant and the adjacent tooth is 2.5 to 4 mm. The distance from the contact point to the interdental bone is recommended to be <7 mm. Papilla presence is also correlated with a thick gingival biotype.