show your work case study Fig. 1 the practice, and we determined that the case would be an ideal candidate for a novice dentist to place an implant. The decision was made to perform the implant as a guided case using the Simplant system. Informed consent was acquired, diagnostic models were taken and the patient booked an appointment to proceed with treatment. Before the surgery date, f inalized implant planning was performed and a Simplant implant placement guide (Fig. 3) was manufactured using data from the CBCT scan and the diagnostic stone model. A 4.8-by-9mm Astra Tech EV implant was selected, based on the available horizontal and vertical bone volume. Fig. 2 A twist in plans On the day of the surgery, the patient was anesthetized and a crestal incision with distal vertical release was performed to expose the surgical site. The Simplant guide was placed on the teeth, ensuring complete seating, and the initial punch osteotomy drill was used to depth. At this time, an unforeseen complication arose with the use of the Simplant guide. While the initial punch drill had a short enough shank to pass through the keyway Fig. 3 dentaltown.com \\ JULY 2017 53http://www.dentaltown.com