The paediatric population rarely suffer malignant disease of the oral cavity requiring any form of maxillectomy, and there is little published evidence around the rehabilitation and restorative management of children undergoing such procedures. The seemingly most common approach for a limited low-level maxillary resection in a child would be to consider resection and simple prosthetic obturation as this allows relatively simple management of the tumour from a surgical point of view as well as immediate functional and aesthetic rehabilitation with a prosthesis. It also allows for full histopathological examination of the resected specimen to ensure complete resection of the tumour before committing the patient to any form of complex surgical reconstruction which could be planned at a later date should the patient wish. The delivery of a maxillary obturator improves quality of life significantly by primarily restoring aesthetic and functional modalities. It also serves as a purpose to allow correct phonation of speech, prevent nasal discharge of masticatory contents and facilitate swallowing. The aesthetic and psychological benefits of facial restoration are paramount in a child undergoing such a procedure. The use of microvascular reconstruction techniques have allowed for autogenous tissue reconstruction of maxillary defects with either soft or hard tissue. The use of a soft-tissue-only reconstruction such as a radial forearm flap in this clinical situation would prevent successful dental rehabilitation as the soft tissue flap provides no support for the dental prosthesis and, apart from the separation of the oral and nasal cavities, provides no advantage for the patient. The use of a composite-bone-containing flap such as the fibula flap has the potential to provide oro-nasal separation as well as bone to support an implant-retained prosthesis, and with the latest digital technologies, this can be provided rapidly in carefully selected cases [8], although this mode of rapid rehabilitation is not available in many centres. However, there is no published data on this mode of dental rehabilitation in a growing child currently, and this approach should probably be deferred until all mandibular growth has been completed. The use of microvascular reconstruction, in addition, carries with it significant clinical risks as well as potential donor site morbidity and flap failure as well as the potential for fibrous union and loss of individual bony segments where multiple osteotomies are required.