Missing teeth in the aesthetic zone are a frequent orthodontic problem mostly due to agenesis, trauma or periodontal involvement. With full aesthetic and functional rehabilitation being the primary treatment goal, all these patients need an interdisciplinary team to jointly perform treatment planning including evaluation of existing alternatives, and comprehensive execution of the chosen treatment approach. When implants came on the market these situations were often enthusiastically managed by single-tooth implant-borne crowns with or without hard and/or soft tissue grafting. However, critical reevaluation of the results in the long run often evidenced not only pink and white aesthetic complications, but also functional issues due to periimplantitis or implant infraocclusion. The cantilever resin-bonded bridge has proven to be a viable alternative which is no longer only considered a long-term provisional but a definitive solution as the nuts and bolts the traditional two-connector Maryland bridge has been successfully overcome by the new single-wing design. However, if patients accept orthodontic treatment, tooth autotransplantation or space closure are predictable long-term strategies which allow to reduce prosthodontic substitution of the missing tooth to mere restorative tooth reshaping, hence offering a minimally invasive solution to the affected patient. The spectrum of existing treatment possibilities for missing teeth in the aesthetic zone will be concluded by presenting an interesting 'out-of-the-box' approach in a young patient with multiple agenesis.