Smile Rehabilitation in a Patient with Maxillary Canine Agenesis: A Case Report

Abstract

Congenital absence of maxillary canines is a rare condition that significantly impacts smile esthetics and oral function. Successful management requires careful consideration of space distribution, occlusal guidance, and patient preferences. A 25-year-old Saudi woman presented with dissatisfaction regarding her smile due to anterior spacing and the absence of both upper canines. She had previously undergone orthodontic treatment 4 years before without achieving successful space closure. Clinical and radiographic examination confirmed bilateral agenesis of maxillary canines with insufficient bone volume for implant placement. The patient declined further orthodontic treatment. The treatment approach involved comprehensive diagnostic planning including wax-up and mock-up procedures, followed by restoration with lithium disilicate veneers. The maxillary first premolars were reshaped to mimic canine morphology. Bonding was performed under rubber dam isolation using light cure resin cement. At the 6-month follow-up, all veneers remained intact with excellent esthetic integration, functional stability, and high patient satisfaction scores. In cases where orthodontic space closure or implant therapy is contraindicated or refused, mock-up guided ceramic veneers can provide predictable esthetic and functional outcomes for patients with bilateral maxillary canine agenesis.