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Article: Volume 14 Number 4 Page 186 - October 2021

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  Orth Update 2021; 14: 186-193

Orthodontics:  Management of lower incisor extraction cases. Part 1: case selection and planning

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Abstract: Extraction of a lower incisor as part of an orthodontic treatment plan is still considered one of the more unusual choices in contemporary clinical practice. There are, however, situations where this treatment choice may be either enforced, or it provides an additional option that can both simplify treatment and increase efficiency. This article examines clinical situations where extraction of a lower incisor is necessary for reasons of poor pathology, position, or when actively choosing this incisor for extraction and maintaining the equivalent of three lower incisors is of benefit to the patient. In the first part of this series, we focus on appropriate case selection and aids to planning. The second part of this series concentrates on problems encountered when extracting a lower incisor, and how these are managed.

Clinical relevance: This two-part series guides clinicians on case selection and management of patients where the final occlusion will result in three lower incisors. It will look at case selection, treatment planning, problems that may be encountered and potential solutions.

Author notes: John Scholey, BDS, FDS RCS (Edin), FDS (Orth) RCS (Edin), MOrth RCS (Edin), MOrth RCS (Eng), MDentSci, Consultant Orthodontist, University Hospitals of North Midlands NHS Trust. Semina Visram, BDS, MJDF (Eng), MClinDent, MOrth RCS (Eng), FDS (Orth) RCS (Eng) Consultant Orthodontist, Birmingham Dental Hospital, Birmingham Community Healthcare NHS Foundation Trust. Yatisha A Patel, BDS, MOrth RCS (Edin), MSc, Post CCST in Orthodontics, University Hospitals of North Midlands NHS Trust. Email:

Objective: The reader will be able to consider extraction of a lower incisor tooth as part of their orthodontic armamentarium.