The esthetics of a patient with a cleft lip and alveolus and missing maxillary lateral incisor is important. A girl, aged 9 years 3 months with repaired left unilateral cleft of primary palate only was referred for orthodontic evaluation of her anterior tooth-crowding. She was unhappy with the unattractive appearance of her maxillary anterior teeth, which were behind her mandibular anterior teeth. Alveolar bone grafting along with canine substitution to replace her missing lateral incisor were recommended for this patient. The post-treatment results were excellent with good occlusion, acceptable profile, and remained stable one year after conclusion of active treatment.

Keywords: Unilateral cleft lip and alveolus, Maxillary lateral incisor missing