The purpose of this case report was to assess whether patient-specific implants (PSI, Xillocs) and soft tissue flaps contribute in reconstructing large mandibular defects. Five patients whose medical situation and history were not suitable for free microvascular bone flaps received PSI implants and were subsequently evaluated. The mean follow-up time was 12 months. The excellent fit, convenient surgery, and esthetic outcome were seen as the major advantages. PSIs can, in the authors' experience, be considered as a useful alternative provided they are well embedded by viable tissue and attached to vital resection margins of the recipient bone. Schlagwörter: 3D printed titanium implant, jaw prostheses, mandibular reconstruction, osteoradionecrosis, patient-specific implant