Mandibular incisor extraction: A treatment alternative for large maxillary midline diastema.

Maxillary midline diastema is a common aesthetic concern of dental patients. Various treatment modalities have been employed to close diastemas. This case report describes an unusual orthodontic treatment approach for a 25-year-old African American female patient with a large maxillary midline diastema of 5mm, bialveolar dental protrusion and unilateral Class III malocclusion. The treatment included one mandibular incisor extraction, followed by retraction of the incisors. At the end of the 16-month active treatment period, favourable aesthetic and occlusal outcomes were attained. Closure of midline diastema, good overjet and overbite with Class I molar relationships were achieved. CLINICAL SIGNIFICANCE: Fixed orthodontic treatment with single mandibular incisor extraction can be an effective treatment choice for a large maxillary midline diastema. With careful selection of the case and treatment planning, successful results can be obtained.