Surgical guides have evolved to the point that they can be created with the aid of computer-assisted tomography (CT) technology. Surgical guides also are used in construction of the prosthesis prior to implant surgery. With existing guide techniques, the prosthesis is screw retained, or cone-shaped temporary abutments may be used to overcome the lack of parallelism of the implants. With the New Twist technique, we are able to create the surgical guide in such a way that optimum bone may be used and the rotational position of the implant may be established for the surgeon and for the laboratory. Custom abutments are inserted at the time of surgery, as is an esthetic, functionally provisional cemented prosthesis. Castings for the finished ceramo-metal bridge are fabricated before surgery is performed. The final prosthesis then is easily constructed by the restorative dentist during just 3 simple patient visits.