message board Supernumerary Lateral Incisor in Bimaxillary Protrusion Case Treatment Options Townies discuss various options in this aesthetic case that most likely will involve some extractions 3Mortho Member Since: 11/18/07 Post: 1 of 8 The patient is a 19.5-year-old male with supernumerary left lateral incisor, skeletal bimaxillary protrusion, gingival smile and deviation of the upper midline to the right, which is his aesthetic concern. The lateral cephalogram shows skeletal bimaxillary protrusion, while the upper incisors show normal inclination. The lower are slightly proclined. If I simply extract the supernumerary tooth, there will be significant spaces in the upper front that will need aesthetic fillings or veneers, but his incisors will be too wide (the centrals are 10mm and the laterals 7mm wide.) Would you extract bicuspids in this case and how would you handle the supernumerary tooth in that case? I would appreciate your opinions very much. n 3/11/2019 justinudm Member Since: 09/29/14 Post: 2 of 8 18 MAY 2019 // orthotown.com In order for this case to be nearly Class 1 occlusion bilaterally, Class 1 skeleton and have a supernumerary with very little lower crowding (other than the COS), there by definition has to be a Bolton issue even with the supernumerary gone.http://www.orthotown.com