Maxillary lateral incisors vary in form more than any other tooth in the mouth except the third molars. If the variation is too great, it is considered a developmental anomaly. Developmental alterations which are most commonly associated with maxillary lateral incisors either unilaterally or bilaterally are microdontia, hypodontia, dens invaginatus and dens evaginatus (talon cusp). Microdontia is a condition where the teeth are smaller than the normal size, which may involve all the teeth or be limited to a single tooth or a group of teeth. However, involvement of single tooth is a rather common condition, especially involving maxillary lateral incisor. Microdontia of maxillary lateral incisor is called as "peg lateral", that exhibit converging mesial and distal surfaces of crown forming a cone like shape. The root on such a tooth is usually shorter than usual. In this article, a case is reported of a young patient with one congenitally missing and one peg shaped lateral incisor. The patient was treated with a combination of orthodontics, periodontal surgery and aesthetic restorative dentistry interventions.

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