Because of the patient's habit of bruxing and clenching and a history of fracturing the many traditional fixed prosthodontic restorations, multiple implants would be placed throughout the maxilla in order to obtain as much support as possible to stabilize the TEETH IN A DAY^TM prosthesis. A zygoma implant was planned for the left side where bone volume in the posterior was minimal (Fig 6, 8a, 9b), and pterygomaxillary implants would be placed to provide additional support for both the right and left posterior areas.

A decision was made to immediately load the maxillary implants based on the fact that the patient did not want to use a complete removable denture and there appeared to be sufficient areas of stable bone anchorage. There was no clinical reason or patient demand to immediate load the mandibular posterior implants because the mandibular anterior crowns and fixed bridge would be retained.