A congenitally missing lateral incisor tooth is commonly associated with both short and long-term clinical dilemmas, particularly for a growing patient. A unilaterally missing maxillary lateral incisor tooth creates a significant dental asymmetry in the critical aesthetic zone of the smile and potentially increases the difficulty of any subsequent orthodontic and restorative treatment. Carefully planned interdisciplinary management is required to address the challenges of anterior dental asymmetry, unilateral orthodontic space closure and to alleviate the concerns that accompany restorative implant placement in the anterior maxilla. The use of skeletal temporary anchorage devices has increased the predictability of orthodontic space closure, particularly for missing maxillary lateral incisor cases which were previously considered to be unsuitable.