Epitheses, also known as craniofacial prostheses, are artificial substitutes for facial defects. The breakthrough for rehabilitation of facial defects with implant retained epitheses came with the development of the modern silicones and bone anchorage. After the discovery of the osseointegration of titanium in the 1960s, dental implants have been made of titanium. In 1977, the first extraoral titanium implant was inserted in a patient. Later, various solitary extraoral implant systems have been developed. Besides, grouped implant systems have been developed, which may be placed more reliably in areas with low bone offering, as in the nasal and orbital region, or the ideally pneumatised mastoid process. Today, even large facial epitheses may be securely retained. The classical atraumatic surgical technique has remained an unchanged prerequisite for successful implantation of any system. This review outlines the basic principles of osseointegration as well as the main features of extraoral implantology.