This report demonstrates the clinical use of a modified, truly anatomic, root analogue zirconia implant for immediate replacement of a right mandibular first premolar. A 22-year-old female patient with chronic apical periodontitis of the right mandibular first premolar was referred and the tooth was carefully extracted. A truly anatomical, root identical, roughened zirconia implant modified by macro-retentions was manufactured and placed into the extraction socket by tapping 3 days later. After 4 months a composite crown was cemented in place. No complications occurred during the healing period. A good functional and aesthetic result was achieved with minimal bone resorption and soft tissue recession at 18 months follow-up. This report describes the successful clinical use of an immediate, single stage, truly anatomical root-analogue zirconia implant for replacement of a single rooted tooth. Significant modifications such as macro-retentions yielded primary stability and excellent osseointegration. This novel approach is minimally invasive, respects the underlying anatomy and aids socket prevention. In addition the procedure saves time and cost, has good patient acceptance as there is no need for osteotomy, sinus lift or bone augmentation.
Keywords: Immediate implant; Root formed implant; Zirconia as material for dental implants; Zirconia implant.