In the last decades, the replacement of missing teeth with implant-supported restorations has become a predictable treatment with excellent long-term results [1]. It is based on the concept of intimate interfacial contact between the bone and functionally loaded dental implants, defined as “osseointegration” by Brånemark et al. [2, 3] and “functional ankylosis or direct bone apposition to the titanium surface” by Schroeder et al. [4]. According to Branemark et al.’s and Schroeder et al.’s clinical guidelines, two main implant designs, two-piece/submerged and one-piece/nonsubmerged, and two surgical protocols, two-stage/one-stage, have been developed. In the two-stage surgical approach, the top of the implant is placed at the level of the alveolar crest, and abutment connection is performed 3 to 6 months later, during a second surgery. In a one-stage approach, the top of the implant is placed above the bone crest, leaving the implant collar to protrude through the soft tissue. Thus, it does not require a second surgery for abutment connection. Many studies have demonstrated comparable outcomes with both implant designs and surgical approaches [5,6,7,8,9,10,11]. Based on current clinical recommendations, the one-stage approach might be preferable to shorten treatment times, while a two-stage submerged approach could be indicated when the implant is not expected to obtain optimal primary stability or in association with GBR [12]. Moreover, comparative studies between the two surgical protocols have highlighted other advantages for non-submerged implants, such as the lack of an interface/microgap between the implant and abutment at or below the alveolar crest level, a more mature soft tissue healing due to the lack of a second-stage surgery, and a smaller crown-to-implant ratio [12]. However, in many of these studies, the two-piece submerged and one-piece nonsubmerged implants were not similar in terms of shape, surface characteristics, height of the implant collar, size, component fit, etc. Furthermore, few clinical studies have been published comparing the two different surgical approaches in the same patient [10, 11]. More robust evidence is still needed to determine whether the two different surgical approaches provide the same satisfactory outcomes over time using implants with the same body design and surface, same thread design and pitch, and identical intramucosal surface. Therefore, the aim of this randomized clinical trial was to evaluate and compare radiographic crestal bone loss (CBL) and soft tissue parameters, using a one-stage vs. two-stage surgical protocols, around single submerged and nonsubmerged implants with the same tapered body design and surface, the same thread design and distance, and identical intramucosal surface (laser-microgrooved), placed in a separate section of the posterior mandible or maxilla of the same patient, after 3 years of loading.