A 49-year-old woman was referred to an oral and maxillofacial surgeon by her family dentist because of severe periodontal disease in the maxilla. Their request was to estimate the feasibility of reconstruction using implants, after the removal of all maxillary teeth. A new method of treatment which makes use of computer tomography, virtual implant planning and a customized surgical template was applied. With the benefit of this method, 4 implants were inserted without bone augmentation, on which a previously constructed superstructure was placed during the same treatment session. This treatment concept makes optimal use of the bone volume available. Additional advantages are the possibility of flapless transmucosal immediate implant insertion and the possibility of immediately placing the superstructure. However, inaccuracies during implant planning and surgical treatment can easily lead to a poor fitting superstructure. Moreover, determining primary implant stability during treatment is difficult.