Purpose: The purpose of this prospective comparative study is to determine the possibility of designing a CAD/CAM patient specific abutment that reproducibly predicts the clinical relationship of the abutment/crown interface with the peri-implant mucosal margin. Materials and Methods: Seventeen patients were allocated to 2 groups of subgingival abutment margin depths: 1.5mm and 0.5mm. A surgical guide, custom abutment and provisional crown were fabricated prior to surgery. Implants were placed in 16 participants using a guided surgery protocol. Results: Five of the sixteen abutments had abutment margin exposure at abutment delivery. Four of the five abutment margin exposures occurred at molar sites. Ten out of sixteen provisional crowns fit with zero adjustment. Conclusions: The results of this pilot study suggest that the digital workflow of producing a definitive titanium abutment and milled provisional crown prior to guided surgery is initially successful. Abutment Margin Exposure is more likely in molar sites.