A panoramic radiograph revealed a missing lower-right second molar and impacted upper- and lower-right third molars. Figure 2. A Cone Beam CT study was performed while the patient was wearing an imaging guide with radiopaque restorative pins seen in the panoramic slice (A) and cross-section (B). These pins represent optimal prosthetically-driven access holes and trajectory for tooth No. 31. Residual bone trajectory and the mandibular canal were also used as guiding basics for implant trajectory, depth/length, and diameter. A 3-dimensional reconstruction of a patient's anatomy was achieved, and a surgical guidance template (C) was designed and computer-manufactured with a precise drilling-hole location and trajectory. Figure 3. The primary sleeve from the metal guiding sleeves system was inserted into a predetermined hole and secured by means of an adhesive to the template. Figure 4. An osteotomy and subsequent implant drilling procedure was performed utilizing the personalized template. Figure 5. The Zimmer implant, 5.7 mm in diameter and 11.5 mm long, was placed in the optimal position, considering the surrounding anatomic landmarks and the patient's occlusion. Figure 6. The final lower-right second molar porcelain fused to metal implant–supported restoration that was cemented in place.