The asymmetric extraction decision.

Orthodontic study models, intraoral photographs, radiographs and diagnostic set-up casts of four completed adult cases are presented to show the possibilities of atypical treatment planning to correct specific and unusual malocclusions. The cases presented required asymmetric dental extractions in order to achieve the desired treatment results. Three diagnostic procedures were used to assist in making the final treatment decisions; a Bolton tooth size analysis, a space available/space needed assessment, and a pretreatment diagnostic set-up. The completed treatment results closely approximate the original diagnostic predictions, and completely satisfied each patient's chief concern. Most orthodontic practices now treat increasing numbers of non-growing (adult) patients. Traditional extraction considerations must be modified to satisfy the treatment needs of this demanding patient population.