It is not uncommon to be congenitally missing the lateral incisors, like this young lady. In this case, she had never had teeth in these spaces before so the gum tissue was very flat. We placed implants in the sites of the missing teeth and placed temporary crowns on top. As the gum tissue healed, we added material to the temporary crowns in order to “shape” the gum tissue in order to create a nice frame for our crowns. Notice the natural scalloped appearance of the gum tissue around the implant crowns in the final picture. When restoring teeth in the front of the mouth, we must pay close attention to the gums. It can make or break the esthetic outcome of the case!