A conservative treatment is presented for a patient with complex severe esthetic problems related to the presence of anomalous teeth. The patient showed a rare occurrence of macrodontia of the maxillary right lateral incisor and microdontia of the maxillary left lateral incisor. The treatment plan was conservative to avoid tooth extraction, periodontal tissue trauma, and the risk of an unpredictable esthetic outcome. A multidisciplinary treatment involving orthodontic extrusion, endodontic therapy, periodontal therapy, and minimally invasive restorations was performed. A successful outcome was observed after a 2-year follow-up.
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