The congenital absence of a maxillary central incisor is a rare condition. This case report described a 16 years old male presented to the Orthodontic Department at Aberdeen Dental Hospital U.K. with a congenitally absent maxillary right central incisor in association with the congenital absence of both maxillary lateral incisors. Multidisciplinary approach with orthodontic space closure of the maxillary lateral incisors and space opening for the maxillary right central incisor followed by an implant replacement was carried out. The rationale for choosing this treatment option and alternative management options were discussed. A good treatment outcome was achieved to manage such a challenging unusual case.

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