Conservative treatment for malaligned permanent mandibular incisors in the early mixed dentition

When mandibular permanent incisors erupt lingually to the corresponding primary tooth, the lingually erupted permanent incisor should be allowed to correct itself. This self correction will usually occur by eight years of age. If the primary incisor is still present at eight years of age, it should be considered overretained. Extraction is indicated. No primary mandibular central incisors are indicated for extraction, when the mandibular permanent central incisors initially erupt malaligned. In addition, if there is an apparent lack of space for the unerupted mandibular lateral incisor after the permanent central incisors have erupted, wait for the permanent lateral incisor to erupt fully. This waiting period allows for maximum intercanine width to occur. Other factors can allow for further improvement of the malaligned mandibular permanent incisors.