Many modifications have been
added to the extraction of primary
canines to improve the results, including
the use of cervical pull headgear,42
double extraction of the primary canine and the primary first molar
the use of a transpalatal arch (TPA),45
and the use of a rapid maxillary expansion
in combination with a TPA.46 All
of these show favorable results as compared
to the extraction of primary
canines alone. The selection of these
modifications should be based on individual
clinical presentations.