Traditional surgical planning of pre-prosthetic surgery Severe oligodontia leads to maxillary retrusion with Class III dentofacial deformity [3]. In these cases, surgical treatment can included a Le Fort I osteotomy with bilateral calvarial bone grafting in the sinuses to improve intermaxillary relationships and increase the bone volume [3,4]. Preoperative planification then required traditionally a dental set-up based on the articulator study, which included a provisional prosthesis to guide the maxillary position during the Le Fort I osteotomy. Toward a digital pre-prosthetic surgical planning The development of digital technology has simplified the management using customized pre-implant and preoperative implant planning, allowing precise prosthetic restoration and optimal aesthetic and functional rehabilitation [1]. Indeed, in patients with edentulism, terminal bone resorption, or large jaws discrepancies because of maxillary retrusion, reduced facial height, and resorption of the mandibular and maxillary alveolar ridges, computer-assisted design facilitates complex restorations Fully digital pre-prosthetic surgical planning Today, computer-aided design and manufacturing (CAD-CAM) of surgical cutting guides is widely used in oral and maxillofacial surgery. Our team has previously reported the use of autologous calvarial bone graft with a CAD-CAM support [8,9]. This digital pre-planned bone graft can therefore be used in addition to digital pre-planned orthognathic surgery, mandibular osteoplasty with bilateral nerve bypass and digital pre-planned implant surgery in a fully digital pre-prosthetic surgery (Figure 2).