Tooth extrusion has been characterized as an undesirable component of presurgical orthodontic treatment because of its alleged role in dental relapse following surgical correction of open bite. A review of current literature and clinical experience suggests that tooth extrusion is a viable and necessary component of presurgical orthodontic treatment. Alternate explanations for relapse following correction of open bite are offered. It is suggested that long-term stability of open bite closure is a product of well-executed treatment and biologic adaptation, and not necessarily the technique of correction.