Classical approach in malocclusion due to supernumerary teeth consists of the extraction of supernumeraries and the rehabilitation of the permanent teeth. Extra tubercules of the supernumerary teeth is a rare condition and it is more uncommon to see this tubercule on the vestibular surface. Surgical and prosthetic approach is planned in this case, because the mesiodens has erupted and it resembled the impacted permanent incisor; so because of the possibility of an unsuccessful orthodontic treatment, surgical and prosthtic treatment is compulsively planned. Left upper central incisor is impacted and a large mesiodens with a prominent talon cusp on the vestibular surface has erupted at the place of the incisor. After the surgical extraction of the impacted incisor a composite laminate restoration was applied on the mesiodens talon with minimum removal at the enamel level of the talon csup. Treatement planning can be made due to the clinical findings of the patients the most important criteria is to handle the treatment planning of the prosthetic rehabilitation of the patient with the minimum harm and as in our case appropriately using the supernumerary teeth
