Esthetic Outcomes of “One Crown One Time” Concept Compared to Conventional Soft Tissue Conditioning in Single Implant- Supported Restorations: A Randomized Controlled Clinical Trial

PURPOSE: To evaluate the effect of one crown one time (1C1T) protocol, in comparison with soft tissue conditioning involving multiple abutment disconnections, on the esthetic outcomes of single implant-supported restorations in healed implant sites. MATERIALS AND METHODS: Twenty-nine patients over the age of 25, each receiving a single implant in the anterior or premolar regions, participated in this study. Half of the submerged implants were restored immediately after uncovering using a final screw-retained zirconia crown, luted to a titanium base. The remaining submerged implants initially received a healing abutment, followed by soft tissue conditioning phase with provisional restorations prior the delivery of the definitive crowns. All patients were followed for 12 months. Esthetic outcomes were assessed using Pink Esthetic Score (PES), analysis of peri-implant soft tissue volumetric alterations, and patient-reported outcome measures (PROMs). RESULTS: The CG and 1C1T group exhibited mean PES of 8.9±2.6 and 10.5±1.6, respectively, at baseline (p >0.05) and of 10.8±2.2 and 11.1±1.2 at 1-year follow-up (p>0.05). Regarding volumetric soft tissue alterations, the CG presented a higher root mean square (RMS) discrepancy (median:336) compared to the 1C1T group (median:192 µm) (P0.05), as well as in 12-months follow-up (P>0.05). CONCLUSIONS: When appropriate surgical and prosthetic protocols are followed, omission of the provisional phase does not compromise the short-term esthetic outcomes of single implant restorations, rendering the one-crown one-time concept a viable treatment alternative.