Segmental mandibular resection due to malignant lesions requires maxillofacial reconstruction which aims to maintain or restore the function, achieve Immediate and compete wound closure and produce aesthetically pleasing result after resection. Microvascular free flap reconstruction offers a stable foundation upon which prosthesis can be fabricated. The most preferred osseous flap is the fibula free flap as it is a vascular pedicle that is long and has a large caliber vessel, good bone quality and capacity to shape the bone through multiple osteotomies. The placement of ossointegrated teeth can nearly entirely reconstruct both shape and function. Positive results have been observed with implants positioned both primary and secondary. Primary implants however showed better results as they permit patients to resume oral nourishment as well as start using prosthesis earlier in their healing process. Its additionally reduces the cost by 24% when compared to the secondary placed implants.