BACKGROUND Missing maxillary lateral incisors create an esthetic problem with specific orthodontic and prosthetic considerations. The purpose of this article is to describe treatment protocols and problems encountered in the management of this disorder. METHODS The two common treatment options are orthodontic space opening for future restorations or orthodontic space closure using canines to replace the missing maxillary lateral incisors. The required amount of space opening and the various prosthetic options are discussed. The methods for reshaping canines in orthodontic space closure and building them up to simulate lateral incisors also are described. The indications, advantages and disadvantages of both treatment modalities are outlined to help clinicians make decisions in borderline situations. CONCLUSIONS Teamwork between the orthodontist, general practitioner and restorative dentist is important when analyzing factors related to individual patients and establishing overall treatment plans. This also will allow treatment modalities and the various options for replacing missing maxillary lateral incisors in space opening to be discussed between team members and the patient.