Early restoration of the masticatory function, phonatory and aesthetics is some of the current goals of the therapy based on endosseous implants. Facing the classic protocols of implant insertion, which recommend a period of several months between extraction and implant placement, alternatives have been developed that demonstrate that immediate implant placement after tooth extraction permits adequate osseointegration, even in those cases where there is a periapical disease. The immediate restoration of implants after placement is a possibility where aesthetic requirements are high. This article presents a case with immediate implant placement and immediate loading of a first upper premolar with prior periapical pathology due to a vertical fracture. The immediate prosthetic was performed using the extracted crown, which is adapted to be attached to a titanium temporary abutment using a resin cement. After a 4 month healing period work began on the final prosthetic crown. The screw crown was made of zirconium oxide with a covering feldspathic ceramic. At the 12-month follow-up, there were no mechanical or biological complications. The patient gave high satisfaction marks for the overall treatment, giving visual analogue scale score of nine. Immediate post-extraction implants have arisen as an alternative to traditional implants on completely healed bone. Their main aim is to reduce treatment time and number of surgical procedures, along with other objectives such as reduced bone re-absorption and improved aesthetics.