A high-risk esthetically driven restorative case requires the dental team, along with the patient, to have a clear vision of the final outcome. In this case of a 33-year-old woman who wanted to improve her smile, esthetic problems stemmed from a retained deciduous maxillary left canine along with an impacted tooth No. 11. Among a number of concerns was the shape and color of the deciduous canine and the uneven length of the maxillary central incisors. A treatment plan that included orthodontics with removable aligners, occlusal adjustment, composite restorations, extraction and implant placement, indirect porcelain veneers, and a custom abutment and PFM crown was successfully executed in four phases over the course of more than 4 years.
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