Agenesis is commonly found in maxillary lateral incisors with a relative high preva- lence. We reported a case of agenesis of the lateral upper incisor associated with dental caries. A 20-year-old man came to Unjani Dental Hospital with a complaint of cavities in the left upper incisor. His only complaint was lack of confidence due to the dental caries; no complaint of pain. At the first visit, anamnesis and clinical examination were performed on him. Oral hygiene was
good. Tooth 63 had moderate caries, vital, no mobility, and the percussion and pressure tests were negative. Radiograph examination revealed agenesis of tooth 22. This case was confirmed as reversible pulpitis of tooth 63, associated with agenesis of tooth 22. First treatment was restoration of the labial surface of tooth 63 using restoration material with the same color (composite). At the
second visit a week after, the examination revealed positive vitality and no more complaint. The purposes of restorative treatment in this patient were to repair caries damage, protect and prevent
further damage of the pulp and other tooth structures, reduce symptoms and pain, restore the tooth function, improve esthetics, support good oral hygiene, and maintain the tooth space and arch. In conclusion, primary teeth can be preserved as a substitute for agenesis teeth. Successfull treatment depends on the collaboration between the dentist and the patient. Keywords: agenesis; primary teeth; lateral incisivus lateral of maxilla