Patients who present with severe maxillary bone loss secondary to trauma, congenital defect, or resorption secondary to prosthesis function provide a unique diagnostic and difficult treatment challenge. This article describes a prosthetic-surgical treatment approach utilizing threaded titanium cylindrical endosteal (Brånemark) implants in combination with iliac bone grafting in nine such patients. Five patients received implant and bone graft placement at the same surgical setting and four patients received the implant 6 to 18 months following bone graft placement. Treatment sequence, surgical technique, indications, and follow-up results are illustrated by abbreviated case reports of four patients.