The use of implants to replace congenitally missing teeth is a-predictable esthetic Solution that is, paradoxically less invasive than the traditional reliance on bridges to supply the missing elements because it demands little or no sacrifice of dental tissue. But this noble goal cannot be achieved unless we can assure prospective patients that the results will be stable and esthetically satisfying over the long term. This is an issue of primordial importance in view of the tender age of the patients that are the usual candidates for this treatment modality for agenesis. And no such assurance can be proffered unless we deal with the problem in a multi-disciplinary fashion from the very outset of treatment planning. We must evaluate the space needed for a replacement not just from the standpoint of the prosthetic requirements alone but also with an assessment of the associated osseous and gingival tissues in the framework of a tri-dimensional implant placement.