Esthetic Management of Maxillary Canine Substitution with Clear Aligner Pretreatment: An Interdisciplinary Approach

Abstract

Congenital agenesis of maxillary lateral incisors presents unique treatment challenges requiring interdisciplinary approaches. This case report article describes the successful management of a 23-year-old female patient with bilateral lateral incisor agenesis who presented with esthetically unsatisfactory composite restorations on her mesialized canines. Treatment involved orthodontic movement using 15 clear aligners over 8 months to optimize tooth positioning, followed by replacement of existing composite restorations using advanced layering techniques. The canines were reshaped to resemble lateral incisors, while the first premolars were reanatomized to function as canines. This case report demonstrates how combining orthodontic preparation with meticulous restorative techniques can achieve excellent functional and esthetic outcomes in canine substitution cases.