Influence of the fixed implant‐supported provisional phase on the esthetic final outcome of implant‐supported crowns: 3‐year results of a randomized controlled clinical trial

Objectives: The aim of this investigation was to evaluate whether the use of a provisional implant‐supported crown improves the final esthetic outcome of implant crowns that are placed within esthetic sites. Materials and Methods: Twenty endosseous implants were inserted in sites 13 to 23 (FDI) in 20 patients. Following the reopening procedure, a randomization process assigned them to either cohort group 1: a provisional phase with soft tissue conditioning using the “dynamic compression technique” or cohort group 2: without a provisional phase. Screw‐retained all ceramic crowns were inserted. Clinical follow‐up appointments were completed at 36 months evaluating clinical, radiographic outcomes, and implant success and survival. Results: After 3 years, all implants survived; one implant‐supported crown was excluded from the study due to adjacent tooth failure replaced with a further implant supported crown. Modified pink esthetic score (ModPES) scores were significantly different between groups 1 and 2 (P = .018); white esthetic scores (WES) were not statistically different between both groups (P = .194). Mean values of combined modPES and WES were 15.6 for group 1, with a SD of 3.20. Group 2 had a mean combined modPES and WES of 12.2, with a SD of 3.86. Mean bone loss after 3 year was −0.05 and −0.04 mm for groups 1 and 2 respectively, without being statistically significant. Conclusion: Fixed implant‐supported provisionals improve the final esthetic outcome of the peri‐implant mucosa.