Introduction: Dental implants are becoming the most efficient treatment option for missing teeth. These are because of their ability to osseointegrate directly into the jawbone and then support dental prosthesis. However, a challenged bone condition may prevent the achievement of an optimal implants placement and then cause clinical complications. One of these conditions could be the focal osteoporotic bone marrow defects (FOBMD).
Case Report: A 22-year-old female was referred with complaint of missing tooth #35. The void was filled using Bio-Oss® bone grafts. Thereafter, Straumann® ITI Dental Implant (ø 3.3 mm, Roxolid®, SLActive®) was immediately placed with a torque wrench with adequate primary stability. Four months after placement, the implant was fully integrated and showed good healing. No clinical abnormality was noted.
Conclusion: The presence of FOBMD does hinder the mechanical stability of dental implants, although it is not negatively affect implants osseointegration from biological point of view. Therefore, we recommend securing the initial stability of dental implants using bone grafting procedure simultaneous the implant placement.

Keywords: Bone grafts, Dental implants, Focal osteoporotic defects, Primary stability