Lower incisor extraction in orthodontic treatment.

The extraction of a single mandibular incisor can be employed as a compromise treatment of certain malocclusions, if the end result fulfills the requirements for a healthier dentition which is functionally and esthetically harmonized in relation to the surrounding structures. Indications, contraindications, and the procedure of treatment have been presented. Class I malocclusions with normal maxillary dentition and good buccal interdigitation in which there is severe lower anterior crowding are the best cases for this procedure, provided that the lower anterior arch length deficiency is greater than 4 to 5 mm. and the anterior tooth ratio is more than 83 mm. In conditions exhibiting a deep overbite pattern, reduction of the mandibular anterior unit should be avoided. Furthermore, I do not regard mandibular incisor extraction as a routine orthodontic procedure but, instead, consider it to be an almost last resort measure since it involves the most important stabilizing area of occlusion.