A mesiodens frequently delays and interferes in the eruption of maxillary central incisors. In the present case, an unerupted mesiodens caused rotation of the permanent left maxillary central incisor. Early detection of mesiodens can prevent occlusal, a esthetic, and psychological problems in young children. Moreover, an early treatment provides for better retention. An early surgical intervention was done to extract the mesiodens and the affected tooth derotated using a semi-fixed appliance. Extraction of mesiodens in early mixed dentition period followed by timely correction of the affected permanent tooth is recommended, thereby lessening the chances of a more complex surgical and orthodontic treatment in future.

Keywords: Supernumerary tooth, mesiodens, derotation