Mandibular incisor extractions in orthodontics: pitfalls and triumphs: a report of three cases

Mandibular incisor extraction therapy has been used as a treatment option since the early 1900s to relieve tooth size-arch length discrepancies in the anterior segment of the mandible. The advantages of this therapy include potential reduction in treatment time, possibility of achieving better long-term stability in the mandibular anterior segment since inter canine width is not increased and maintenance of the soft-tissue profile because retraction of the mandibular incisors is less compared with mandibular premolar extractions These advantages are counterbalanced, however, by some potential disadvantages. The most significant of these is the possibility of the space reopening in the long term, an occlusal result less than ideal because of a significant tooth-mass reduction in the anterior mandibular region, development of an open gingival embrasure and the need for permanent or long term retention. We present three cases with three different indications for mandibular incisor extraction where the patient was benefited despite this atypical extraction pattern.