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Each abutment change after implant exposure disrupts soft tissue remodeling. OAOT (One Abutment One Time) eliminates this problem by limiting abutment changes to just one — from implant uncovering to the final prosthetic restoration.
Each abutment change after implant exposure disrupts soft tissue remodeling. OAOT (One Abutment One Time) eliminates this problem by limiting abutment changes to just one — from implant uncovering to the final prosthetic restoration.
OAOT means placing a single abutment at the time of implant exposure and not removing it until the final prosthetic restoration is delivered. No temporary changes to check position, no test abutments.
The protocol described by Cohen et al. (2012) in clinical studies showed significant improvement in the preservation of the interdental papilla and gingival margin compared to conventional procedures involving multiple abutment changes.
The soft tissue around an implant forms a biological seal (junctional epithelium) comparable to the dentoenamel junction. Each abutment change mechanically disrupts this seal — the tissue begins remodeling from scratch.
With multiple changes: the tissue does not stabilize, the gingival margin recedes, and the interdental papilla does not fill the space. Result: black triangles, aesthetic asymmetry.
With OAOT: the tissue stabilizes around a single shape. After 4–8 weeks, the emergence profile is formed and ready for impression taking.
Step 1 — Exposure During implant uncovering, you place the final or healing abutment with the planned shape for the definitive restoration. This abutment remains in place.
Step 2 — Shaping the Emergence Profile If necessary, you modify the emergence profile using composite or a temporary crown placed on the same abutment. The abutment is not removed.
Step 3 — Impression or Scan After 4–8 weeks, when the tissue is stable, you take an impression or scan. The emergence profile is fully formed and can be replicated in the laboratory.
Step 4 — Final Restoration The final crown or bridge replicates the emergence profile from the impression/scan. No remodeling stages have been disturbed.
| Criterion | OAOT | Conventional Procedure |
|---|---|---|
| Esthetic Zone | Preferred | Acceptable |
| Single Implant | Preferred | Acceptable |
| Multi-implant Bridge | Possible (with coordination) | Usually applied |
| Immediately Loaded Implant (ISQ ≥70) | Yes | Yes |
| Healing Disturbances | Cautious | Acceptable |
LABORATORY PERSPECTIVE
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3SHAPE · ITERO · MEDIT · DENTSPLY SIRONA