As one of the developmental disturbance in shape of teeth, a twinning has very rare frequency in permanent teeth. Because it is possible to diagnose the twinning by use of the radiograph, it is very important to detect this anomaly early by careful examining the radiographs. The twinning produces several orthodontic problem such as crowding, protrusion, ectopic eruption of adjacent teeth. Therefore it is necessary, in proper time, the extraction and orthodontic treatment should perform.