The 13-year-old man with one impacted and three missing bicuspids has mild protrusive lips (Fig.1,2).  Cephalometric tracing shows SNA and SNB being 88 and 87 degree, respectively, indicating bimaxillary protrusion.  Is the evidence strong enough for extraction?

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Xin Wei, DDS, PhD, MS 1st edition 03/12/2018, last revision 03/25/2018