The Team Approach to Replacing the Congenitally Missing Lateral Incisor: Restorative and Periodontal Considerations

The replacement of congenitally missing maxillary lateral incisors can be a challenge from both a restorative and surgical perspective. The restorative dentist is limited in achieving esthetics by the surgical result not only by the implant position but by the surrounding periodontium of the site itself, as well as the adjacent teeth. The present case, replacing congenitally missing lateral incisors with an immediate provisional restoration, is important because it demonstrates the ideal team approach. By each clinician participating in stage I surgery, the restorative dentist and periodontist can work toward an optimal result. The combination of restorative expertise and regenerative enhancements simultaneously can result in a minimally invasive approach with fewer appointments and greater patient acceptance. Case Presentation: This case report demonstrates the restorative and surgical considerations and techniques for prefabrication of screw‐retained provisional restorations placed at the time of surgery. Surgical considerations and techniques to support the restoration position, size, and screw retention connection are also presented. Conclusions: Close communication between treatment team members is critical to achieving predictable esthetics and function for congenitally missing maxillary lateral incisors. The participation of the restorative dentist at stage I surgery is critical in demanding esthetic cases such as this. Periodontal hard and soft tissues respond well to prefabricated screw‐retained provisional restoration delivered at the time of surgery.