Aesthetic Rehabilitation In Congenital Maxillary Lateral Agenesis Guided

Anterior teeth deficiency result in aesthetic concerns and complex treatments. Often, an interdisciplinary approach involving orthodontic, periodontal, and prosthetic treatments is necessary due to space limitations and irregular gingival margins. This case illustrates the periodontal and prosthetic rehabilitation of the anterior maxillary region, highlighting the necessity of prosthetic restorations to achieve optimal aesthetic outcomes when orthodontics alone is insufficient. A 24-year-old woman with congenital missing lateral incisors.The teeth were properly aligned on the right side; however, there was a significant diastema present on the left side. The patient had previously undergone orthodontic treatment and refused additional orthodontic procedures. After stage 1 treatments were completed, and the patient received a digitally prepared wax-up, followed by gingivoplasty. After a two week waiting period, full crown preparations were performed on 23, 21, 11, 13, while laminate veneer preparations were applied to 14, 15, 24, to ensure sufficient space for lateral incisors and to prevent color discrepancies. Lithium disilicate restorations were cemented using an adhesive cementation protocol. This treatment provides optimal aesthetics and function as an alternative to orthodontic and surgical extraction in cases of congenital tooth deficiency. In some cases, it may be challenging to foresee treatment outcomes and understand the necessity for additional interventions. Utilizing a mock-up helps clinicians and patients visualize potential results. Asymmetric diastema and congenitally missing teeth can present significant clinical challenges. Understanding the limitations of the mock-up allows clinicians to better shape patient expectations and achieve satisfying aesthetic outcomes.