The 72-year-old patient has been treated with seven titanium Straumann implants and a double-sided sinus lift in the upper jaw over 20 years ago. The two implants on 24 and 25 had to be removed due to severe peri-implantitis and bone resorption. The patient wanted to know, whether a further implant soluton is possible. After evaluation of the X-ray images, a new restoration on the basis of three implants in the second quadrant was proposed, in the distal area bone augmentation via an internal sinus lift. The patient asked if a metal-free restoration is possible. The implants used were the new Zeramex XT implants with screw-retained abutments (Dentalpoint). The bone replacement material used was maxresorb inject (botiss).