Agenesis of all permanent maxillary incisors: A rare clinical case with an interdisciplinary solution

BACKGROUND: Clinical cases involving agenesis of all four maxillary incisors are rare, with no previous reports in the literature. CASE REPORT: The present case report describes an orthodontic treatment combined with esthetic dentistry in a 10-year-old girl with agenesis of all four permanent maxillary incisors, anterior crossbite, permanence of deciduous maxillary canines and transmigration of permanent maxillary canines into the region of the maxillary central incisors. For this case, it was decided on space closure using a fixed orthodontic apparatus and reshaping of the first premolars transforming them into canines. Porcelain veneers were used on the permanent and deciduous canines, substituting the maxillary central and lateral incisors, respectively. Regarding outcome, there was an improvement in facial profile, correction of the anterior crossbite, satisfactory intercuspidation of the teeth and significant esthetic improvement in smile. Maintaining the patient´s natural dentition also kept the bone plate intact for future placement of implants to substitute maxillary deciduous canines at the appropriate age. CONCLUSIONS: Interdisciplinary planning combining orthodontics and esthetic dentistry was key in resolving this case. Key words:Tooth agenesis, upper incisors, orthodontic treatment.