PMC6497487_01
Non-restorable tooth #11 due to ongoing external root resorption.
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The patient was provided with complete information regarding treatment options to make a decision for tooth extraction and implant placement of #11 (Figure 1).
Immediate implant placement.
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The placement and torquing of a Zimmer implant were ensured at 40 N cm (Figure 2).
Implant temporary abutments placed on the casts.
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Two implant temporary abutments from Zimmer (Zimmer Dental, Carlsbad, Calif) were placed on the cast and prepared using the clear vacuum-formed shell template (Figure 3). 
Implant supported provisional fixed dental prosthesis.
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Occlusion was adjusted to ensure minimal contacts during eccentric and centric occlusion (Figure 4). 
Evaluation of esthetics and phonetics on visits at first day, 4 weeks, 8 weeks, 12 weeks, and 16 weeks.
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Esthetics and phonetics were evaluated and the patient displayed a complete satisfaction with the outcome (Figure 5). 
Soft-tissue maturation at the time of impression taking.
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A definitive open tray impression was done by using Impergum Penta-Soft after 4 months of healing (Figure 6).
Definitive impression using customized impression coping and impergum impression material to transfer the emergence profile to the master cast.
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The soft tissue emergence profile was transferred to the mastercast using light body polyvinyl siloxane material (Figure 7). 
Customized zirconia abutment.
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Abutment design of implant #11 was requested to match the design of gold abutment #21 except in material. The abutment designed for implant #11 was fabricated from zirconia for comparison purposes. An approval from the prosthodontists was taken via email for the abutment design (Figure 8). A one-piece customized abutment which consisted entirely of zirconia was milled and shipped to the clinic. 
Abutments' thickness evaluation using apolygauge.
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Thickness evaluation was made using a polygauge and all the readings were equal on both crowns in all sections (Figure 9). 
Final crowns cemented with temporary cement.
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Finally, customized abutments were torqued to 30 N cm, access hale were blocked with Teflon tape, and the final crowns were cemented with non-eugenol temporary cement (Temp Bond NE, Kerr; Orange, CA, USA) (Figure 10).  
Final picture of teeth restoration.
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The patient was satisfied with the esthetics and functional outcome of the final restorations, as was the prosthodontist (Figure 11).