The function of the space maintainer is to preserve arch length following the premature loss of a primary tooth. The space maintainer allows the permanent tooth to erupt unhindered into proper alignment and occlusion. The lingual holding arch is commonly used in the lower arch space maintenance. It is common to see the ectopic eruption of a permanent first molar due to the premature loss of a primary molar. In this article, a modified lingual holding arch is used in the premature loss of a second primary molar and mesial tilting of a permanent molar. It is successful to upright the permanent molar and has been followed up for two years.