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The extraction of single mandibular incisor has always led to debate regarding midline and smile esthetics. The current case report describes the effect of mesiodens in worsening the Class II Division 1 malocclusion and its correction by extraction of mesiodens, upper first premolars, and single mandibular incisor. Satisfactory functional and esthetic results were achieved with well-settled Class II molar, Class I canine relationship, ideal overjet, and overbite. Two years postretention records show stable results

Does midline coincidence of upper and lower teeth affect smile aesthetics?