Reconstruction of large craniofacial defects requires several factors to be considered before deciding on the best reconstructive option. This article discusses various factors taken into consideration when deciding on which reconstructive option is ideal for a given patient and defect. For large craniofacial defects, reconstruction using tissue transfer is considered preferentially over obturation, although in select defects obturation using a traditional tooth- or implant-borne prosthetic obturator can be considered a viable option.