A 6 year old male patient, with no pathological history of interest, came to the dentistry clinic for a check-up. The intraoral examination showed exfoliation of the four upper incisors without eruption of any of the permanent incisors. Palpation revealed a swelling in the vestibular cortex corresponding to the crowns of the upper central incisors, but these were located very far from the midline. An orthopantomography was requested to assess the position and eruption status of the upper incisors. The radiograph showed the presence of two midline mesiodens. The one on the right side was in a more apical position and larger than the left one. Both were vertical and conoid in shape. They caused a large interincisal diastema and prevented the correct eruption of the upper central incisors. The mother was informed of the need to extract the supernumerary teeth for the correct eruption of the anterior teeth, and the patient was referred to the maxillofacial surgery department for surgical extraction of the mesiodens. Prior to surgery, the patient had erupted 1/3 of the crown of the left upper incisor and the cusp of the left mesiodens. The maxillofacial surgery department decided to carry out the operation in two phases: first the surgical exodontia of the left mesiodens was carried out and the right mesiodens when it was in a lower position. The patient will require periodic check-ups to control the eruption of the teeth and to assess the need for subsequent orthodontic treatment to close the interincisal diastema and also to allow the eruption of the upper lateral incisors.