To assess the clinical outcome of three esthetic implant‐supported crown systems fabricated with semi‐digital workflow and their influence on the clinical outcome of dental implants.

A total of 30 participants had received dental implants restoring missing maxillary first/second premolars. After 6 weeks, customized zirconia abutments were early loaded. Two months later, the definitive crowns were fabricated using semi‐digital workflow and cemented. According to the crown material, 3 groups were randomly allocated; group (Z): ultrahigh‐translucent monolithic zirconia, group (C): resin‐matrix ceramic and group (P): polyetherketoneketone veneered with light‐cured composite resin. Clinical outcomes including the survival and success rates were evaluated at baseline, 6, 12, 18, and 24 months.

The survival rate for all studied groups was 100%, while their success rate was 100% for group (Z) and 90% for group (C) and group (P). Based on the functional implant prosthodontic score, a statistically significant difference was detected between group (Z) and group (P) (p < 0.001) as well as between group (C) and group (P) (p = 0.01).

The zirconia group had the most favorable clinical behavior, while the polyetherketoneketone had the least. All crown systems had comparable success rates with similar values of the peri‐implant marginal bone loss.

Using semi‐digital workflow, ultrahigh‐translucent monolithic zirconia, resin‐matrix ceramic and polyetherketoneketone veneered with light‐cured composite resin can be considered as favorable implant‐supported crowns. The implant‐supported crown system based on polyetherketoneketone veneered with light‐cured composite resin is counted as a promising esthetic and restorative option.