Combined orthodontic surgical approach in the treatment of impacted canines allowed eruption of intra osseous maxillary impacted canines at the centre of the alveolar ridge surgical approach must preserve the soft tissues to avoid any recession or periodontal damage at the end of treatment 5 . Therapeutic management of the impacted teeth was combined with orthodontic treatment of a class ii division 1 malocclusion a sequential approach of surgical removal of the supernumerary teeth with 2 stages of surgical exposure and orthodontic traction of the impacted teeth resulted in proper incisor positioning. Combined surgical and orthodontic treatment this is the most satisfactory option with a combined surgical and orthodontic approach and impacted tooth can be brought to the ideal position therefore achieving esthetic and function. This article presents a case with a horizontally impacted and severely dilacerated maxillary right incisor that was aligned into proper position after orthodontic treatment combined with surgical exposure and apicoectomy after which it showed good long term periodontal stability. Impaction of maxillary permanent incisors is not a frequent case in dental practice but its treatment is challenging because of these teeth importance to facial esthetics management by a combination of orthodontics and surgery produces a satisfactory result
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