The most important consideration in Orthodontics is, do the teeth remain in good alignment and does the overbite correction remain permanently? If these two characteristics remain stable, it matters little whether the ANB angle is 0, 1, 2, or 3 degrees.

I hope I will be pardoned for a personal reference. Recently I was speaking before a woman's club, and I was relating some important procedures which make for permanent treatment results. One of the ladies in the audience spoke up and said, "Now I see why other orthodontists' patients need their teeth straightened twice, while your patients do not."

An individual may have three or four degrees after his name, be in great demand as a clinician, be able to use the English language with great flair, be able to write a superb manuscript, and still not be aware of what is most important in clinical Orthodontics.

We have listed the procedures which, if accomplished, will produce a high degree of stable treatment results. These procedures are listed in Article One on the Internet. For the convenience of the reader, we will list them here.

1. When overbite has been reduced to 1 mm,
2. When upper incisors are about 24 degrees to line NA and have been appropriately intruded if needed,
3. When the lower arch has been completely leveled without intruding the incisors, without expanding the cuspids, and without moving the incisors forward,
4. When good cuspid interdigitation has been achieved and tested for permanency (we should not hesitate to remove enamel from the appropriate teeth to accomplish this), and
5. When the case has been carefully retained with a fixed retainer from cuspid to cuspid, then post treatment growth will usually improve the superior result.

Fig. 1. (Post treatment growth of a female patient covering a 5-year period between the ages of 13 and 18 years. Please note that there was very little vertical growth of the maxilla and no increase in anterior dental height. Since the case was well treated and retained with a canine-to-canine retainer, all teeth remained in good alignment, the mandibular teeth maintained a constant relation to their base, and the maxillary teeth were driven forward. Of special interest is the fact that upper molars and pogonion moved forward about an equal amount.

When all of the above has been accomplished, then post treatment growth will usually translate or tip the upper molars and bicuspids forward, tip the incisors and cuspids forward, reduce the overjet, improve or maintain the overbite and improve the interdigitation. Please see Fig. No. 1.

We read a great many articles on the subject of stable treatment results, but very few if any of them ever list the really important procedures. If one is convinced down deep in their soul that these procedures are correct, then the individual will work hard to accomplish them. It will give enthusiasm and zest for the practice of Orthodontics. It will give spiritual satisfaction. Please see Figs. 2 to 13. This overwhelming evidence verifies the importance of avoiding the intrusion of lower incisors, stimulating the growth of lower molars, adequately torquing the upper incisors, and intruding the upper incisors when needed.

These tracings were done by an expert-not by the author. In the last thirty-five years nobody has told me that they agree with my views on the management of the lower incisors. That gives one a lonely feeling. Nobody has published an agreement with my views-nevertheless I am firm in my convictions.

Out of a burning desire to get the point across, it was decided to publish overwhelming evidence that it is not necessary to intrude lower incisors in most growing patients. Because, when lower incisors have been intruded, the upward movement, post treatment, of these teeth is the prime cause of bite closure. When molars are moved occlusally, they remain at this level permanently.

Fig. 2 Before and after record of lower arch showing manner of correction of occlusal curve. All posterior teeth grew upward to the level of the incisors. The second molars moved 2mm distally and the incisors did not move forward.	Fig. 3 Showing a treatment record of a male age 12 years, 10 months to 14 years, 11 months. Lower incisors were not intruded and did not move forward.
Fig. 4 Same patient shown in Fig. 3. An ANB angle of 11.5 degrees	Fig. 5 Treatment record of same patient shown in Fig. 3. All lower posterior teeth were moved upward to the level of the incisors. Incisors were not intruded.
Fig. 6 Treatment record showing manner of correction. All lower teeth were moved distally.	Fig. 7 Showing a treatment record where 11 mm of overbite was corrected without intruding lower incisors. The lower incisors were moved too far lingually. We should have extracted 2nd bicuspids instead of 1st bicuspids.
Fig. 8 Showing manner of correction of the occlusal curve. Same patient shown in Fig. 7.	Fig. 9 A treatment record showing that the lower incisors were not intruded, were not moved forward, and the 2nd molars were moved 2 mm distally.
Fig. 10 A treatment record of a patient with 12 mm of overbite. The overbite was reduced to zero, the lower incisors were intruded 1 mm and did not move lingually.	Fig. 11 This shows overbite of 10 mm and -3 mm of upper incisor to NA.
Fig. 12 This is the same patient shown in Fig. 11. Here, 10 mm of overbite was corrected without intruding the lower incisors.	Fig. 13 A treatment record in which the lower incisors were excessively intruded (A). In the post treatment period, the lower incisors again grew vertically and closed the bite accordingly. (B).

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