Considering the age of the patient, clinical and radiographic findings, and the following treatment was decided upon. Guiding the mesiodens to the edentulous area could provide a unique advantage of bridging the anterior space and prevention of the use of a prosthesis at such a young age. The procedure was explained to the parents and the patient, and their approval sought. After routine blood examination, using a labial approach, surgical exposure of the labial aspect of the supernumerary tooth was attempted. A closed exposure of the mesiodens was preferred to enable an orthodontic eruption along with its periodontal attachment. The mesiodens revealed a flat labial surface of mesiodistal width of approximately 6 mm, with 3-4 mammelon like structures at its incisal edge. Simultaneous bonding of an orthodontic bracket to the exposed labial aspect was found appropriate (Figure 2). A surgical approach, at this juncture, for the removal of the permanent tooth, could jeopardize the root of the mesiodens and impede proper alignment and cause bone loss in that region. Using light traction with elastics, the mesiodens was gradually guided to the position of the missing central incisor (Figures (Figures33 and and4).4). After the root of the mesiodens had descended, the child was subjected to surgical extraction of the malformed permanent tooth, under local anesthesia. As rightfully assessed in the radiographic series, the root of the permanent incisor was rudimentary and dilacerated and narrow with a possibility of cessation. Aesthetic restoration of the mesiodens was carried out with anterior composites (Figure 5). The patient was extremely satisfied with her appearance after the treatment. After eruption of the permanent left canine, adjunctive procedures may be appropriate to distalize the left lateral incisor with fixed orthodontic therapy to accommodate a crown as large as the adjacent central incisor, for better aesthetics.