Objectives: This article reports the management of a facial shotgun wound reconstructed with vascularized free fibula flap in combination with both endosseous implant and tooth retained overdenture in order to achieve optimal anatomical, esthetic and functional results. Methods: Surgical reconstruction of the mandible with a vascularized free fibula flap provided enough bone stock to insert implants. Both the osteointegrated dental implants and the teeth were used to restore stability of the overdenture. The prosthodontic phase of the treatment was completed using standard protocol. Tooth and implant retained overdenture provided a good function and esthetic. Results: The patient was followed–up for 4 years without any evidence of implant instability, abutment loosening, or ball attachment failure and tooth mobility Conclusion: Reconstruction of dental arch with vascularized free fibula flap allows the placement of osteointegrated dental implant, and a surgical restoration of normal face projection. In addition, the use of osteointegrated dental implants is an effective approach to restore the function and stability of the removable prosthesis.

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