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Transpositions are rare anomalies where there is an exchange of positions between two adjacent teeth. Treatment, ideally involves alignment of teeth, consideration for aesthetic, social and functional purposes. This article/ case report describes transposition in two sisters of age 11 and 14 year and discusses the treatment possibilities for aesthetic and functional needs. The treatment considerations encompass comprehensive caries management: restorative and endodontic treatments including a gutta percha obturation of a pulpally involved primary molar for delaying the resorption, preventive care and regular follow-ups until definitive treatment.