Comprehensive Management of Spacing in the Maxillary Anterior Region with Congenitally Missing Lateral Incisors in a 12-Year-Old Child: A Case Report

Hypodontia, defined as the congenital absence of one or more teeth (excluding third molars), is a common developmental anomaly with significant esthetic, functional, and psychosocial consequences, particularly when it involves the anterior region. The maxillary lateral incisors are among the most frequently missing teeth, and their absence during the mixed dentition stage requires comprehensive treatment planning. This case report describes the multidisciplinary management of a 12-year-old girl with congenitally missing maxillary right and left lateral incisors, associated with a high labial frenum attachment and tongue thrusting habit. The treatment protocol involved sequential steps of habit interception using myofunctional exercises followed by a fixed tongue guard appliance, frenectomy, orthodontic space creation with open coil springs, and interim prosthetic rehabilitation with a removable partial denture. This staged approach successfully restored function and esthetics, while also addressing the psychosocial needs of the patient. The case highlights the importance of early diagnosis and timely intervention in pediatric patients with hypodontia to establish a stable foundation for future definitive treatment. Keywords: Hypodontia, Tongue thrusting habit, Frenectomy, Orthodontic space creation, Prosthetic rehabilitation