Objective: The authors present a clinical report of three complex cases with patients with defects in maxilla. One patient with oroantral fistulae promoted by implants and extraoral graft complications. The other patient with a secondary oroantral communication after failure of iliac bone reconstruction associated to a Lefort I advanced. The last one presented a nasal and oroantral communication by postmaxillectomy sequelae. All patients were treated with zygomatic implants. One patient was rehabilitated with fixed prostheses and the other patients with obturator prostheses. A total of 10 zygomatic implants were placed. In two patients quad zygomatic implants technique was used and in the other two zygomatic implants associated to standard implants were performed. The patients were followed up for a period of 5 years.

Conclusion: The rehabilitation of atrophic maxillae with zygomatic implants is a predictable treatment option for rehabilitation of complex cases.