Abstract
An erupted mesiodens can cause displacement and rotation of the maxillary incisors, which may impact a child's smile aesthetics and their confidence. This case report presents a non-compliance method for correcting maxillary incisor rotations in the mixed dentition using a modified transpalatal arch in combination with a sectional fixed appliance. The patient was a nine-year-old male who presented in the mixed dentition with a Class I incisor relationship on a Class I skeletal base with an erupted mesiodens, upper arch crowding, and severe (110°) rotation of the right maxillary central incisor. De-rotation of the incisor was accomplished within 17 weeks with preservation of periodontal health and gingival aesthetics. The clinical significance of this case report is that the modified transpalatal arch offers a simple and compliance-free approach for correcting severe maxillary incisor rotations and is a practical alternative to removable appliances in the mixed dentition.