The expanded experience with oral implants and supplementary augmentation techniques has opened new possibilities for treating patients with oligodontia or anodontia with fixed prostheses. A problem in treating such patients is the need to place implants in growing maxillae or mandibles, as many of these patients are children or adolescents. When implant treatment is postponed until the patient is full grown, dysfunctions become manifest, which necessitates extensive surgical measures to achieve a fixed prosthetic restoration. This report illustrates the problems associated with different concepts for the treatment of multiple aplasia with implants. The results are based on the findings of 22 patients with oligodontia who underwent surgical treatment and were followed over a period of 5 years. Two controversially treated cases are presented.