Purpose: The aim of this study was to report the outcome of using a maxillary osteotomy with an interpositional bone graft and implants in the treatment of extremely resorbed maxillae. Materials and Methods: Twenty-two consecutive patients (mean age 65.7 years) were included in the study. Bone grafts from the iliac bone were used. The patients were followed in a standardized clinical and radiographic method for up to 5 years. Results: A total of 176 Astra Tioblast ST implants were placed. Six implant losses occurred. All patients had fixed prostheses. Only minor bone resorption (1.0 to 1.5 mm) occurred in the bone graft, as well as a certain amount of marginal bone remodeling around the implants (1.0 to 1.9 mm) during periods up to 5 years. Remodeling and resorption in the bone graft and around the implants occurred during the first postoperative year. The results represent cumulative sucess and survival rates of 97%, which is comparative to implant integration in conventional maxillary bone. Discussion and Conclusions: The orthognathic surgical technique using maxillary osteotomy with interpositional bone graft and implants in a 2-stage procedure has been shown to be a predictable and reliable method for rehabilitation of patients with extreme resorption of the maxilla when conventional implant surgical methods cannot be used. Although the procedures are trying for the patients, overall satisfaction with the end result can be rewarding. Keywords: bone grafting, dental implants, maxillary osteotomy