A unilateral congenitally missing maxillary lateral incisor is often associated with a small or peg-shaped contralateral tooth. This form of hypodontia is also frequently combined with a generally undersized maxillary dentition, which could therefore be considered a paradigm for esthetic situations where problems of tooth position, size and form need to be connected and resolved. The space opening versus the space closure option should derive from a hierarchy of decisions. When we treat young patients, the restorative solutions should be obtained by a minimally invasive approach, which facilitates both the reversibility and ease of reintervention in the long term. (Semin Orthod 2020; 26:24-32)
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