Minimally invasive implant rehabilitation in the esthetic zone: A case report of immediate implant and tooth preservation with a year radiological follow-up.

Abstract This case report highlights a conservative and patient-centered approach to implant rehabilitation in the esthetic zone. A patient presented with concerns about a visible retained upper tooth and malformed adjacent tooth, causing esthetic dissatisfaction. Clinical examination revealed a retained root of the upper right first premolar and a malformed upper right second premolar, both suggestive of developmental anomalies. The treatment planning was to extract only the retained root of the first premolar and place an immediate implant, while preserving the second premolar with a porcelain-fused-to-metal (PFM) crown, avoiding the need for a second implant. Preoperative cone beam computed tomography (CBCT) imaging guided implant positioning, and postoperative CBCT confirmed precise implant placement. A radiological follow-up at one year demonstrated stable osseointegration, healthy peri-implant bone levels, and functional prosthesis with no complications. This case underlines the importance of individualized treatment planning and clinical judgment in preserving tooth structure, optimizing esthetics, and minimizing surgical intervention. The use of immediate implant placement combined with conservative tooth restoration yielded a successful functional and esthetic outcome. Keywords: CBCT, conservative treatment, developmental tooth anomaly, esthetic zone, immediate implant, retained premolar.