In my daily work and online, many patients ask me if I can extract only one lower incisor for orthodontic treatment, and there are concerns of one kind or another about this unconventional treatment. In fact, it is sometimes possible to extract the mandibular incisors during the reduction of malocclusion, but there is still much controversy among clinicians regarding the indications and orthodontic characteristics of the extraction of mandibular incisors. However, many studies have shown that with strict selection of indications, treatment results can be very good. The indications for extraction of mandibular central incisors are generally considered to be: (1) Ann’s Class III malocclusion (“geodontia”/retrognathism); (2) Bolton Index abnormalities (that is, disproportionate size of upper and lower teeth); (3) simple lower dental crowding; (4) mandibular incisors completely aligned outside the dental arch; (5) mandibular incisors (5) Crowded and thin basal bone, with distal-central inclination of the cuspids; (6) Class III malocclusion tendency (i.e., anterior teeth are close to “diastema”), with crowded mandibular incisors. Of course, the extraction of mandibular incisors is also prone to some problems, such as deep overdentures, open gaps in the anterior teeth, poor posterior dentition and loss of lower anterior interdental papillae (gingival atrophy between teeth), but it can be avoided if adequate attention is given during the orthodontic treatment. The orthodontic treatment of this extraction is simple and short, so some doctors or patients prefer to use this treatment, but clinical orthodontic treatment must be strictly selected for indications and should not apply extraction of mandibular central incisors for orthodontic treatment simply to shorten the course of treatment. The orthodontic treatment may need to be combined with the use of methods such as adjacent surface enamel removal (slight grinding of smaller teeth) and the use of gentle orthodontic forces to prevent interdental papilla loss and gingival recession. Two of my cases are attached below: Patient 1 before treatment Patient 1 after treatment Patient 2 before treatment Patient 2 after treatment