The goal of an implant supported reconstruction is to obtain optimal aesthetics and function. In order to achieve this, visualisation of the final restorative reconstruction is necessary prior to beginning treatment. The term ‘restorative-driven’ treatment planning has been used to identify this process. It requires a team approach of specialists, who can develop a multi- disciplinary treatment plan. It starts with an accurate diagnosis, which will lead to a prognosis of each individual tooth and the overall dentition. This information will help the clinician develop the treatment options suitable for tooth replacement. Only when the goals have been defined can the sequence of therapy be established. Working backwards from the wax-up of the final diagnostic model of the proposed treatment assists not only with the management of the complex case, but will help avoid mishaps. Effective communication between the team and the patient is extremely important. Understanding the patient’s expectations is key to a successful outcome. Deciding that these expectations are realistic requires a correct diagnosis and an inter-disciplinary treatment plan that is logical. This approach takes time and requires a comprehensive treatment discussion between the team members, and then a thorough case presentation to the patient. Only then will the patient begin to understand the extent of their problem and the options available to reconstruct their mouth.