Mandibular incisor extraction therapy

Extracting a mandibular incisor has been stigmatized as an expedient that may adversely affect the occlusion. However, when properly used, the extraction is only one aspect of the total correction of the malocclusion. Failure to observe this will fulfill the negative predictions. Articulating six maxillary with five mandibular anterior teeth necessitates a visualization of the posttreatment occlusion, and therefore specific criteria for case selection are essential. Treatment trends oscillate between nonextraction and four premolar extractions, with perhaps insufficient attention currently given to alternatives. This middle of the road approach is indicated in carefully selected cases, especially where space requirements and facial esthetics do not call for greater dental movements.