A case report of tooth agenesis and excessive intraarch space due to tooth size discrepancies and malformed teeth is presented. Interdisciplinary treatment including orthodontics, implant surgery, prosthodontics, and laboratory fabrication with dissimilar restoration and material types was used to accomplish an esthetic and functional outcome. Proper diagnosis of individual tooth width and proportion were key elements in treatment. CLINICAL SIGNIFICANCE: Knowledge and understanding of the relationships of the mandibular to maxillary anterior teeth and shade management of dissimilar restoration types will allow the interdisciplinary team to achieve the desired esthetic restorative result.
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