In some instances, it may be difficult to make this decision. Treatment planning for such patients should consist of an initial though relatively conservative attempt to expand the arches, while evaluating the result. If the patient tolerates arch expansion well and does not develop excessive incisor protrusion, expansion treatment may ultimately be successful in spite of a relatively large discrepancy. On the other hand, if the expansion proceeds with difficulty and the signs of excessive arch expansion, primarily incisor protrusion and labial tipping of the teeth, begin to appear, uncertainty about the correctness of a decision to extract teeth has been removed.
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