Application Status and Prospects of "One-Abutment One-Time" Concept in Implant Restoration

doi:10.13701/j.cnki.kqyxyj.2025.12.003

Abstract

Abstract: Conventional implant restoration often involves repeated assembly and removal of components, which can damage the mucosal barrier, displace fibrous tissue, and cause marginal bone loss. To address this, the one-abutment one-time (OA-OT) concept, introduced by Degidi in 2011, advocates placing the final abutment at the time of implant placement or during the second-stage surgery. This approach avoids multiple adjustments of healing abutments, transfer bars, and restorative abutments, reducing trauma to peri-implant tissues. While studies suggest that OA-OT placement preserves more peri-implant bone, its impact on the long-term stability of soft and hard tissues remains debated. This review explores the effects and application prospect of OA-OT on peri-implant tissue stability.

Key words: one-abutment one-time, marginal bone loss, hard tissue preservation, soft tissue preservation

LIN Hailu, WANG Linhong. Application Status and Prospects of "One-Abutment One-Time" Concept in Implant Restoration[J]. Journal of Oral Science Research, 2025, 41(12): 1030-1036.

References

[1] Abrahamsson I, Berglundh T, Lindhe J. The mucosal barrier following abutment dis/reconnection: An experimental study in dogs [J]. J Clin Periodontol, 1997, 24(8): 568-572.
[2] Lazzara RJ, Porter SS. Platform switching: a new concept in implant dentistry for controlling postrestorative crestal bone levels [J]. Int J Periodontics Restorative Dent, 2006, 26(1): 9-17.
[3] Todescan FF, Pustiglioni FE, Imbronito AV, et al. Influence of the microgap in the peri-implant hard and soft tissues: a histomorphometric study in dogs [J]. Int J Oral Maxillofac Implants, 2002, 17(4): 467-472.
[4] Degidi M, Nardi D, Piattelli A. One abutment at one time: non-removal of an immediate abutment and its effect on bone healing around subcrestal tapered implants: One abutment at one time: the effect of the non-removal of an immediate abutment [J]. Clin Oral Implants Res, 2011, 22(11): 1303-1307.
[5] Listgarten MA, Lang NP, Schroeder HE, et al. Periodontal tissues and their counterparts around endosseous implants [J]. Clin Oral Implants Res, 1991, 2(3): 1-19.
[6] Berglundh T, Lindhe J. Dimension of the periimplant mucosa. Biological width revisited [J]. J Clin Periodontol, 1996, 23(10): 971-973.
[7] Berglundh T, Lindhe J, Ericsson I, et al. The soft tissue barrier at implants and teeth [J]. Clin Oral Implants Res, 1991, 2(2): 81-90.
[8] Ivanovski S, Lee R. Comparison of peri-implant and periodontal marginal soft tissues in health and disease [J]. Periodontol 2000, 2018, 76(1): 116-130.
[9] Abd Wahab MA, Mohd Yusof E, Ahmad R, et al. Peri-implant Bone Healing: Its Basic Osteogenesis and Biomarkers [J]. Malaysian Journal of Medicine and Health Sciences, 2022, 18(6): 324-331.
[10] Terheyden H, Lang NP, Bierbaum S, et al. Osseointegration-communication of cells [J]. Clin Oral Implants Res, 2012, 23(10): 1127-1135.
[11] Insua A, Monje A, Wang H, et al. Basis of bone metabolism around dental implants during osseointegration and peri-implant bone loss [J]. J Biomed Mater Res A, 2017, 105(7): 2075-2089.
[12] Kim JJ, Lee JH, Kim JC, et al. Biological responses to the transitional area of dental implants: material- and structure-dependent responses of peri-implant tissue to abutments [J]. Materials (Basel), 2019, 13(1): 72.
[13] Kim JC, Lee M, Yeo ISL. Three interfaces of the dental implant system and their clinical effects on hard and soft tissues [J]. Mater Horiz, 2022, 9(5): 1387-1411.
[14] Di Stefano DA, Arosio P, Capparè P, et al. Stability of dental implants and thickness of cortical bone: clinical research and future perspectives. A systematic review [J]. Materials (Basel), 2021, 14(23): 7183.
[15] Gao SS, Zhang YR, Zhu ZL, et al. Micromotions and combined damages at the dental implant/bone interface [J]. Int J Oral Sci, 2012, 4(4): 182-188.
[16] Grandi T, Guazzi P, Samarani R, et al. One abutment-one time versus a provisional abutment in immediately loaded post-extractive single implants: a 1-year follow-up of a multicentre randomised controlled trial [J]. Eur J Oral Implantol, 2014, 7(2): 141-149.
[17] Wang QQ, Dai R, Cao CY, et al. One-time versus repeated abutment connection for platform-switched implant: A systematic review and meta-analysis [J]. PLoS One, 2017, 12(10): e0186385.
[18] Vatenas I, Linkeviius T. One abutment one time vs. repeatable abutment disconnections in implants, restored with cemented / screw retained fixed partial dentures: Marginal bone level changes. A systematic review and meta-analysis [J]. Stomatologija, 2021, 23(2): 35-40.
[19] Erhan Çömlekoğlu M, Nizam N, Çömlekoğlu MD. Immediate definitive individualized abutments reduce peri-implant bone loss: a randomized controlled split-mouth study on 16 patients [J]. Clin Oral Investig, 2018, 22(1): 475-486.
[20] Hartlev J, Kohberg P, Ahlmann S, et al. Immediate placement and provisionalization of single-tooth implants involving a definitive individual abutment: a clinical and radiographic retrospective study [J]. Clin Oral Implants Res, 2013, 24(6): 652-658.
[21] 张丽丽,王远勤,李镭.同期永久基台影响种植体周围组织变化的随机对照研究[J].口腔医学研究,2018,34(5):522-526.
[22] 王新,袁鼎翔,吴丹,等.前牙美学区即刻种植永久基台即刻修复后唇侧骨三维变化的定量分析[J].北京口腔医学,2021,29(4):232-237.
[23] Canullo L, Omori Y, Amari Y, et al. Five-year cohort prospective study on single implants in the esthetic area restored using one-abutment/one-time prosthetic approach [J].Clin Implant Dent Relat Res, 2018, 20(5): 668-673.
[24] Rathi P, Kolte RA, Kolte AP. Peri-implant tissue health in bone-level implants with repeated abutment replacements versus tissue- level implants with a definitive abutment: A randomized controlled trial [J]. Int J Periodontics Restorative Dent, 2022, 42(2): e33-e42.
[25] Calatrava J, Sanz-Sánchez I, Molina A, et al. Effect of one-time placement of the definitive abutment versus multiple healing abutment disconnections and reconnections during the prosthetic phase on radiographic and clinical outcomes: A 12-month randomized clinical trial [J].Clin Implant Dent Relat Res, 2024, 26(5): 998-1011.
[26] Praça LFG, Teixeira RC, Rego RO. Influence of abutment disconnection on peri-implant marginal bone loss: A randomized clinical trial [J]. Clin Oral Implants Res, 2020, 31(4): 341-351.
[27] Sanz-Sánchez I, Molina A, Martin C, et al. The effect of one-time abutment placement on clinical and radiographic outcomes: A 5-year randomized clinical trial [J]. Clin Oral Implants Res, 2024, 35(6): 609-620.
[28] Atsuta I, Yamaza T, Yoshinari M, et al. Changes in the distribution of laminin-5 during peri-implant epithelium formation after immediate titanium implantation in rats [J]. Biomaterials, 2005, 26(14): 1751-1760.
[29] Gulati K, Moon HJ, Kumar PTS, et al. Anodized anisotropic titanium surfaces for enhanced guidance of gingival fibroblasts [J]. Mater Sci Eng C Mater Biol Appl, 2020, 112: 110860.
[30] Fujii N, Kusakari H, Maeda T. A histological study on tissue responses to titanium implantation in rat maxilla: the process of epithelial regeneration and bone reaction [J]. J Periodontol, 1998, 69(4): 485-495.
[31] Sculean A, Gruber R, Bosshardt DD. Soft tissue wound healing around teeth and dental implants [J]. J Clin Periodontol, 2014, 41 Suppl 15: S6-S22.
[32] Tallarico M, Caneva M, Meloni SM, et al. Definitive abutments placed at implant insertion and never removed: Is it an effective approach? a systematic review and meta-analysis of randomized controlled trials [J]. J Oral Maxillofac Surg, 2018, 76(2): 316-324.
[33] Degidi M, Nardi D, Daprile G, et al. Nonremoval of immediate abutments in cases involving subcrestally placed postextractive tapered single implants: A randomized controlled clinical study [J].Clin Implant Dent Relat Res, 2014, 16(6): 794-805.
[34] Esposito M, Bressan E, Grusovin MG, et al. Do repeated changes of abutments have any influence on the stability of peri-implant tissues? One-year post-loading results from a multicentre randomised controlled trial [J]. Eur J Oral Implantol, 2017, 10(1): 57-72.
[35] Pelekanos S, Pozidi G. Immediate one-time low-profile abutment to enhance peri-implant soft and hard tissue stability in the esthetic zone [J]. Int J Periodontics Restorative Dent, 2017, 37(5): 729-735.
[36] Molina A, Sanz-Sánchez I, Martín C, et al. The effect of one-time abutment placement on interproximal bone levels and peri-implant soft tissues: a prospective randomized clinical trial [J]. Clin Oral Implants Res, 2017, 28(4): 443-452.
[37] Bienz SP, Pirc M, Papageorgiou SN, et al. The influence of thin as compared to thick peri-implant soft tissues on aesthetic outcomes: A systematic review and meta-analysis [J]. Clin Oral Implants Res, 2022, 33(Suppl 23): 56-71.
[38] Tang P, Meng Z, Song X, et al. Influence of different mucosal phenotype on early and long-term marginal bone loss around implants: a systematic review and meta-analysis [J]. Clin Oral Investig, 2023, 27(4): 1391-1407.
[39] Hanozin B, Li Manni L, Lecloux G, et al. Digital vs. conventional workflow for one-abutment one-time immediate restoration in the esthetic zone: a randomized controlled trial [J]. Int J Implant Dent, 2022, 8(1): 7.
[40] Waltenberger L, Wolfart S. SafetyCrown: a patient-centered, fully digital concept for immediate implant restoration following the one-abutment/one-time concept-a pilot case series of a new treatment concept [J]. Int J Implant Dent, 2022, 8(1): 35.
[41] Jiang J, Yang H, Zhu H, et al. Clinical efficacy of a two-piece abutment conforming to the concept of one abutment one time in the posterior region: A clinical pilot study [J].Clin Implant Dent Relat Res, 2024, 26(4): 763-776.
[42] Nagy P, Szurok L. Full digital implant workflow utilizing the one-abutment one-time concept [J]. J Denti, 2022, 121: 104030.
[43] Pascoal ALB, Paiva KRG, de Araújo LNM, et al. One-piece versus two-piece abutments for single crowns in the esthetic zone: A clinical trial [J]. Clin Oral Implants Res, 2025, 36(2): 143-152.
[44] Trimpou G, Schwarz F, Begi A, et al. Clinical performance of immediately placed and restored progressive-type implants in the esthetic zone: a prospective observational study [J]. Int J Implant Dent, 2022, 8(1): 57.
[45] Lambrechts T, Doornewaard R, De Bruyckere T, et al. A multicenter cohort study on the association of the one-abutment one-time concept with marginal bone loss around bone level implants [J]. Clin Oral Implants Res, 2021, 32(2): 192-202.