Class II correction: Extraction or nonextraction?

The patient with a Class II malocclusion, proclination, or moderate crowding of the mandibular anterior teeth, and a moderate-to-low mandibular plane angle is a treatment-planning challenge. The records of 3 patients are presented. For 2 of them, extraction treatment was used to resolve the Class II malocclusion problem. Each of these patients was treated with the removal of maxillary first premolars and mandibular second premolars. The third patient was treated with Class II elastics without extractions. The clinician must weigh the pros and cons of each approach and decide which approach will give the patient the best long-term benefit.