The restorative dentist treates patients with needs taht often transcend dental disciplines. This dentist will be responsible for long-term dental maintenance and should logically oversee interdisciplinary reconstruction. This case report demonstrates an integrated treatment approach and 5-year retrospective study involving a patient with maxillary anterior excess, pronounced overjet, and advanced periodontitis. Extraction and radical alveolectomy with removable prosthesis is often considered in such cases; however, results are often less than optimum function, esthetics, and general oral health. In this case, a previously undescribed anterior maxillary rotating segmental ostectomy was integrated with restorative, periodontal, and removable full and partial denture procedures.