Extraction versus non-extraction debate has been a major controversy in orthodontics and it is still continuing since Angle era. Extraction of premolar teeth is the conventional treatment of choice for the management of class I malocclusion cases but in border line cases, orthodontists find difficulty in making a decision particularly in cases with good facial esthetics. However class I malocclusion with arch length tooth tissue discrepancy can be managed with the extraction of a lower incisor tooth. This would produce a more acceptable aesthetic outcome. Lower incisor extraction becomes a therapeutic alternative to premolar extractions in cases of lower anterior crowding and cases with well occluded posterior teeth.
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