Patients often present with congenital and acquired tooth loss, traumatic injuries, and it is incumbent on the prosthodontics team to diagnose educate and provide care plans that address the range of issues concerning the young adult needing tooth replacement therapy. The challenge in treating patients with missing teeth in young adult patients and concomitant malocclusion, particularly in the long-term is how to achieve the best esthetic and functional results. The diagnostic phase is critical and involves an interdisciplinary team. Auto-transplantation of teeth and orthodontic space closure represent viable biological approaches for replacement of incisors because of the permanence of the result, particularly in growing individuals. Even if solid comparative research data for the different replacement methods so far are not available, a compilation of all treatment modalities can produce treatment results that are almost indistinguishable from an intact dentition. This will lead to progressive care plans that engage removable, fixed, and implant prosthodontics with an eye to a multidisciplinary approach. This paper will review the critical points of assessment, key points to consider, and then provide clinical examples of care plans for the transitional adult in our practice. The goal should be that patients who have received treatment for missing teeth will have treatment results that are indistinguishable from normal appearance. A prerequisite is that the therapy is based on a complete diagnosis, that the indications for the selected approach are present, and that attention to detail throughout treatment is exercised by all involved in the treatment.

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Dens invaginatus (DI) is a developmental abnormality of the tooth resulting in the invagination of the enamel organ into the dental papilla before the calcification of dental tissues. DI is one of the common dental deformities, but its association with the radicular cyst (RC) is still very uncommon. Oehler’s Type 3B DI has a deep invagination that extends apically communicating with the apical area. This allows the entry of irritants predisposing for dental caries, periapical lesions, and pulp pathology if there is a communication with pulp. The sequelae of undiagnosed and untreated coronal invaginations include abscess formation, retention of neighboring teeth, displacement of teeth, cysts, and internal resorption. Identifying this anomaly early will prevent further complications. This presentation describes a case of RC associated with Type 3B DI in a permanent maxillary lateral incisor in a 9-year-old girl. A brief review of both pathologies is also discussed.