Supernumerary teeth in the maxillary midline can present both esthetic and pathologic concerns that can be difficult to solve. The frequency with which supernumerary teeth occur justifies an oral radiographic survey for preschool children as early detection is most important, if such complications are to be avoided or minimized. The case presented in this report required both surgical and innovative orthodontic therapy to bring an unerupted, impacted maxillary central incisor into proper alignment. The tooth was moved into the dental arch and injury to the root structure and surrounding oral tissues was avoided by using a combination of conservative surgical and orthodontic therapy.

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