In this modern orthodontic era, smile aesthetics determines the success of any orthodontic treatment as it has an impact on the patient’s quality of life. The esthetics is compromised when there is a missing, malformed or impacted anterior tooth. The greatest challenge is arriving at a treatment plan when confronted with a case which has the combination of all the above-mentioned abnormalities. Approaching such cases require a comprehensive treatment plan which contemplates the options of whether to extract and replace it with prosthesis or to expose the canine and orthodontically align the teeth. This case report describes an effective management of a 25-year old male patient with impacted canines, malformed and missing lateral incisors through a multifaceted approach. Substituting the lateral incisors amended the smile esthetics of the patient. At the end of 20 months of multi-faceted treatment, the results were superior in terms of esthetics, functional efficiency and patient comfort.
