The installation of fixtures for prosthetic reconstruction in maxillofacial surgery in patients with bone and soft tissue defects is still a challenge. Until now, computer-assisted preoperative planning and surgery has not been practiced as part of the surgical routine. Advances in imaging techniques and associated technologies have led within the past years to improved preoperative planning for the oral and maxillofacial surgeons. Imaging, planning and navigation techniques in our clinical centres serve for computer assisted preoperative planning and computer assisted surgery. The patient’s individual anatomy is assessed in multiplanar (axial, coronal, sagittal) and three-dimensional views. The use of computer assisted treatment allows virtual insertion of dental implants according to prosthodontic needs. Especially the complex anatomy due to previous surgical procedures demand specific treatment for a precise and safe insertion of the implants. On the base of a CT data set a 3D-toothborn device was used for intraoperative controlling of insertion of dental implants. The software allowed virtual insertion of implants, with different diameters and length. Insertion of dental implants with or without previous bony reconstruction of the maxilla and mandible was performed in over 700 patients. This improves preoperative planning by valid 3D visualization of the anatomic situs and virtually positioning of the fixture. It facilitates the clinical procedure by guiding the drill and the implant to the intended position. The use of navigation systems instead of 3D-templates will be discussed critically.