Composite maxillary defects are best recontructed by osteocutaneous free flaps. Fibula osteoseptocutaneous free flap provides both bone and soft tissue for three dimensional reconstruction. Placement of osseointegrated dental implants is also possible. Simultaneous osseointegrated dental implantation allows faster rehabilitation, reduces both operative sessions and cost. Between August 1999 and July 2001, 3 patients received maxillary reconstruction with fibula osteoseptocutaneous free flap and simultaneous osseointegrated dental implants. One patient was operated because of maxillary defect as a result of adenoid cystic carcinoma resection and the other two patients had traumatic deformities. Fibula osteoseptocutaneous free flap was used in all patients and simultaneous osseointegrated dental implants were inserted. The mean length of the bone used was 4.7 cm and the skin island sized 8x2.5 and 16x3.5 in two patients. Double skin island (6x4 cm and 6x5 cm) were used in the other patient for both oral and nasal reconstruction. Two osseointegrated implants were inserted to the fibular bone in each patient. Second stage was necessary to cover the implant necks with either palatal flaps or grafts. One month after second stage prostheses were placed without problem. All patients have been using the prostheses effectively with a mean follow-up of 30 months and were satisfied with functional and cosmetic results.