Parents and dentists are forced to make a decision early in a young patient's life when it is learned that the lateral incisors are missing. For many years the treatment has been to either move the cuspids into the lateral incisor sites s or retain the teeth in their natural environment and restore the defect with a bonded or fixed bridge. With the advent of new designs in dental implants and their abutments, it is possible to consider replacing missing single teeth with implant-borne prostheses. Often-times, because of the limited residual bone and proximity of adjacent roots, placing conventional cylinder or screw-type implants is difficult. This article demonstrates the advantages of using a tapered-step implant, immediate one-stage surgery, and temporization in replacing congenitally missing laterals.