Placing an implant immediately into extraction sockets provides a distinct advantage over delayed placement, eliminating the need for a 4 to 6 months waiting period for bone formation. However, when patients present with hypothyroidism, the feasibility of immediate placement of dental implants becomes uncertain. This case involved a hypothyroid woman in her late 60s with loose lower anterior teeth. We performed atraumatic extractions. Immediately after extraction, we implanted tilted implants into her lower posterior arch, which is an area with limited vertical bone height. In the anterior arch, which is characterized by thick, soft tissue, we implanted vertical implants. We used multiunit abutments in the anterior region to address hygiene and angulation issues. The final prosthesis comprised a porcelain-fused-to-metal screw-retained bridge with group function occlusion. These prostheses offer advantages compared with cement-retained prostheses, particularly with multiunit abutments that allow passive prosthetic fitting despite implant axis deviation. This approach strengthens the hemidesmosomal connection, reduces the need for repeated screwing and unscrewing, and promotes stability in the peri-implant tissues. This case underscores the clinical benefits of immediate implant placement and the advantages of using screw-retained prostheses in patients with hypothyroidism. Although extensive research has been conducted to analyze factors influencing the success of dental implants in individuals with hypothyroidism, ongoing debates persist in the literature. This case demonstrates successful implantation of dental implants in a patient with hypothyroidism.
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