Current osseointegrated implants have high success rates in rehabilitative treatments, even in challenging cases, thanks to advances in computed tomography, virtual planning, surgical techniques, biomaterials, and implant macrogeometry. This study aimed to report a clinical case of upper lateral incisor rehabilitation with extra-narrow implants using guided surgery with the hybrid technique. An 18-year-old patient with agenesis of the upper lateral incisors, previously treated with temporary implants, underwent scanning of the upper arch for virtual planning and surgical guide fabrication. After explantation of the temporary implants, two extra-narrow implants (Ø 2.9 mm) were installed, followed by temporary restoration. After six months, Variobase® prosthetic abutments and zirconia crowns were installed. The patient was satisfied with the esthetic and functional results. Clinical and radiographic follow-up for 19 months showed adequate peri-implant bone and gingival maintenance. The proper three-dimensional positioning of the implants proved to be fundamental for the preservation of the crestal bone and the formation of papillae. It is concluded that extra-narrow implants are an effective and predictable alternative for the rehabilitation of areas with reduced mesiodistal space and low masticatory demand, especially in the replacement of upper lateral incisors and lower incisors.
