Technological advances allow us to offer patients immediate replacement of multiple teeth in dental implant therapy. To achieve predictable esthetic and functional results, a comprehensive diagnosis and treatment plan incorporating the final prosthetic design must be completed. Surgical and restorative dentists require a thorough understanding of prosthetic design, surgical site assessment, patient preparation and implant placement. Long term case presentations will demonstrate the necessary skill sets for comprehensive, immediate and minimally invasive implant reconstruction. We will discuss extraction with immediate implant/provisional restorative protocols with cross arch stabilization for full arch reconstruction with tilted and traditional four to six implant platforms. "Flapless" maxillary full arch reconstruction with CT generated/CAD surgical guides will be presented with both delayed and immediate loading. Additionally, we will review minimally invasive hard and soft tissue management/augmentation, provisional restoration and final prosthesis design.