The closure of large congenital or postsurgical oronasal defects is a challenging problem for both the surgeon and the prosthodontist. Closure of the defect, whether it be by soft tissue or in combination with a bone graft, may reduce the potential for prosthesis extension and retention. This article describes the surgical-prosthodontic treatment for three patients utilizing the placement of titanium fixtures to support the prosthesis. Treatment sequence, surgical procedure, and follow-up results are described. Keywords: oronasal implants, osseointegrated implants, tissue integrated prosthesis