It is understood that one-piece implant design is a stronger concept as there is no connection between implant and abutment. The absence of a microgap can lead to minimal peri-implant bone loss. Furthermore, there is a reduction of mechanical complications such as screw loosening and abutment fractures. These implants can be immediately placed and can be put through instant function because of their high cortical stabilization. This immediate function protocol has advantages over two-stage surgical placement. Other benefits are fewer surgical appointments, reduced treatment time, and minimal trauma. It is suggested that one-piece implant can be an alternative to conventional implants for edentulous arches where there is a resorbed bone in width and height. Initially, one-piece implants were used as transitional or provisional implants. However, because of biological osseointegration, their removal often became difficult. Several manufacturers obtained approval for its use in defined situations. Proper treatment planning avoided comorbidity associated with augmentation procedures and acceptable esthetic result was achieved.

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The peri-implant tissue remodeling just after implant surgery forms a coagulum that occupies the space between mucosa and implant. This is invaded by neutrophils and a barrier forms around implant consisting of dense fibrin network. In another 2 weeks post surgery, it is replaced by connective tissue and vascular structures. In the crestal area, the proliferation of epithelium takes place and forms a junctional epithelium. The barrier epithelium around the implant matures in 6–8 weeks. Formation of biological width begins when the implant gets exposed to the oral environment. This could be through healing screw or prosthetic abutment depending on connection to the implant. It is said that thin or thick tissues have different approaches to healing as the blood supply is varied. Flap is raised during the second stage of implant surgery damaging the blood supply of surrounding tissues. Thin mucosa present around the implant crestal area might lead to more bone loss but not thick tissues as more blood vessels are present here. Bone turnover can lead to crestal bone loss up to 3.2 mm apical to soft-tissue margin. The thickness of the tissues may be a recognized biological factor that might lead to crestal bone stability. In this report, we describe three cases where bone remodeling was camouflaged by thick soft tissues around implant-supported restorations.