Herpes zoster, also known as shingle, is an infection caused by Varicella-zoster virus (VZV), and it results from reactivation of endogenous latent VZV infection within the sensory ganglia. There are several complications of herpes zoster, but only limited reports of osteonecrosis with teeth exfoliation have been addressed. In this case report, we documented a prosthetic reconstruction utilizing the tilited implant in severe mandibular osteonecrosis and spontaneous teeth exfoliation after an outbreak of herpes zoster infection. Tilting implant with angled abutment was selected combining with straight implants, which provided an alternative and simple solution for post-shingle outbreak patient associated with an extensive osteonecrosis and teeth exfoliation to effectively reconstruct the oral masticatory function.