Patients with advanced orofacial cancer may require extensive surgical resection; the wider and more evident is the amputated region, the more this condition is generating inability for patients [6]. Visible head site mutilation and functional impairment in speech prevent social reintegration, and abnormal self-perception leads patients to depression [6].

Even if modern surgery offers many techniques for reconstruction such as free flaps and rotation flaps, they are not indicated in all clinical cases. Because of the huge number of surgical sessions often required in reaching the wishing result, the use of local or microvascular flap could not be indicated in case of elderly patients or patients affected by cardiovascular or metabolic diseases. Moreover, a multistep surgical planning is not advisable in the absence of a complete sure compliance of the patient to the treatment [9]. Furthermore, recipient site complication can occur before and after harvesting or radiotherapy, when required, shall compromise the healing of the flap [9].

Nowadays, prosthetic extraoral rehabilitation is effective, less invasive because no additional surgical procedure is required, cosmetically satisfying and leads patients to a precocious social reintroduction. Additionally, intraoral restoration such as palatal obturator may allow speech and swallowing which play a crucial role in the retrieval of social life [8, 10].

Nasal defects are classified into partial, total and extended rhinectomy referred to soft tissue resection, bone and soft tissue amputation and bone and soft tissue associated to the maxilla or orbital excision [10].

Extraoral defects are usually restored by means of silicon epithesis; intraoral ones necessitate maxillary rehabilitation. In our case, since the premaxilla was lost, no implant insertion in the anterior region was possible. The importance of anterior implant anchorage is well documented even if a higher failure rate than the ones placed in the posterior maxilla is demonstrated [8, 10, 11].

In palatal cleft iatrogenic defects, implants insertion depends on bone residual amount, alveolar ridge height, radiotherapy and peri-implant soft tissue conditions [8, 10]. In patients who undergone radical surgery, all these requirements are often unfavourable and zygoma implants represent a valid alternative in offering prosthetic anchorage [2, 6, 10].