Multidisciplinary management of congenitally missing bilateral maxillary lateral incisors: A case report

Congenital agenesis of maxillary lateral incisors presents a complex restorative and orthodontic challenge, often requiring multidisciplinary management. This case report describes the orthodontic and prosthetic management of bilateral congenitally missing maxillary lateral incisors in a 28-year-old female. Clinical and radiographic evaluation revealed bilateral Class I molar relationships, Class I skeletal base, average-to-horizontal growth pattern, generalized anterior spacing, mild mandibular anterior crowding, and scissor bite involving the first premolars. Orthodontic space regaining was planned to facilitate subsequent implant-supported prosthetic rehabilitation. PEA brackets were bonded, followed by levelling and alignment. Bilateral lateral incisor spaces were regained using open-coil spring mechanics with appropriate torque and root control. The patient was placed in retention using Essix retainers incorporating a temporary prosthesis. Orthodontic space regaining followed by implant-supported rehabilitation provides a conservative treatment option for congenitally missing maxillary lateral incisors, preserving adjacent teeth and periodontal structures while facilitating definitive prosthetic replacement.