Traditionally, missing and hopeless teeth have been replaced by threaded cylindric implants. Implant manufacturers have tried to design implants that more closely resemble tooth anatomy, but the neck and abutment connection areas have not changed much in the past 30 years. Some companies have produced titanium implants with scalloped contours, but the clinical application of this remains uncertain. The combination of anatomically oriented implant designs, newer biomaterials such as zirconia ceramics, and modified surfaces has resulted in dental implants that can be specially designed for the replacement of individual teeth in both arches. Ovoid zirconia implants have been specially developed and produced to replace missing or hopeless premolars. This article discusses the treatment of a patient with an ovoid zirconia implant (CeraRoot Type 14) to replace a premolar.