Severe mandibular alveolar ridge resorption is usually observed in patients with long-term edentulism and/or ill-fitting dentures. In some of these patients, the genial tubercles project into the floor of the mouth as a high point in the anterior area of the mandibular residual ridge. The lingual flanges of mandibular stock impression trays usually impinge on the most prominent areas of the resorbed mandibular edentulous ridge (i.e., internal oblique lines and genial tubercles). It is suggested that a preliminary custom tray be made in such cases to pour an initial impression so that individual custom trays can be fabricated. An efficient method for constructing such a custom impression tray from readily available materials is described.