Since the fit, stability and esthetics of his new dentures were optimal, they were flasked, using alginate impression material, to create a set of clear duplicate dentures to be used in the TIAH procedure. Radiopaque markers were placed in both clear dentures and a CT scan using the cone beam i-CAT machine was taken with the clear dentures in his mouth.

A second scan was taken of the dentures alone, placed on a special platform in the i-CAT scanner.Pre-operative panoramic radiograph. The digital information from the i-CAT scans was reformatted and the virtual surgery implant placement was performed for both arches. This information, along with the casts and bite registration, allowed for the fabrication of the surgical guide and the final prosthesis. Fourteen months after insertion of his dentures and 3 months after scanning, Tom came in for his mandibular TIAH treatment.

Under local anesthesia, the surgical guide was secured with three horizontally placed intraosseous anchor pins. The soft tissue was removed from the implant sites using a counterbore through the guides. The usual sequence of site preparation with appropriate drills was followed and six Nobel Biocare 4 x 15 mm MK III Groovy implants were coated with Protein Rich Plasma then placed according to the computer guided locations in the mandible. The anchor pins and surgical guide were removed and the abutments were placed in the final restoration, which was then secured into position. The screw access holes were sealed with cotton and Fermit. Tom received both verbal and written post-op instructions as well as medications. Four days later Tom reported that he was doing great - no pain or swelling.