Patient presented with crowding in the upper and lower arches and asymmetric bite with all the upper teeth on the left side being more forwards in comparison to the right side. The upper dental centreline was deviated to the right due to the displaced upper right canine. The upper left second premolar was 180 degrees rotated and displaced in the palate. We decided to have the upper left second premolar extracted as it was 180 degrees rotated and we needed space to correct the upper centreline, create space to align the displaced upper right canine and correct the bite the left side.