Missing or Extraction of a Mandibular Incisor in Orthodontics

Abstract

The extraction of a mandibular incisor constitutes a non-conventional alternative in treating certain anomalies. It is not a standard approach to symmetrically treating most malocclusions, but in some clinical situations the therapeutic aim must be adjusted to individual patient needs, even when this means that achieving final occlusion is not ideal. This treatment option may be indicated in malocclusions with anterior tooth size discrepancy due to narrow maxillary incisors and/or large mandibular incisors. It is contraindicated in malocclusions without anterior discrepancy or with discrepancies caused by large maxillary incisors and/or narrow mandibular incisors. The literature suggests that this method affords improved post-treatment stability compared with premolar extraction. A careful diagnosis, established with the aid of a diagnostic setup, professional skills and clinical experience are instrumental in achieving successful orthodontic results with this treatment option. The deliberate extraction of a mandibular incisor in certain cases allows the orthodontist to improve occlusion and dental esthetics. This article highlights the importance, indication, contraindications, advantages, disadvantages and stability of the results achieved in treatments performed with mandibular incisor extraction. Two clinical cases are presented illustrating the modality of such a treatment.