The concept of single tooth replacement with implant was very popular in recent ten years. The mandibular first molar usually was lost in early age due to dental decay, failed to endodontic treatment, and crown fracture (most after endodontic treatment). This study presents the clinical outcome of posterior single tooth implant replacement (3i 4.0 or 5.0 mm Diameter Certain implants) which had been followed within 5 years in CGMH. 219 patients with 242 posterior single implant reconstructions were included in this study. The data were collected from 2008 to 2013. Three of implants (1.2%) failure were noticed in the first year due to loss of osseointegration. Overall, posterior single implant reconstruction should be a reliable treatment option for posterior missing tooth replacement.