患者，男，11岁，下颌面部呈相对后退位，口唇闭合呈现口唇肌肉紧张，覆<img src="/Image1/41/416d70c5ce8bf1e24cd865a81ac5ece8.jpg" />5mm，覆盖9mm，四个第一磨牙Ⅱ类<img src="/Image1/41/416d70c5ce8bf1e24cd865a81ac5ece8.jpg" />关系，上前牙拥挤明显，ANB为10.0°，SNA为84.5°，X线片显示四个第三磨牙存在，下颌Spee曲线明显。对此患者拔牙应设计（）<br>A:拔除<img src="/Image1/d2/d2da76bc41a1fb809220fa262acccabc.jpg" /><br>B:拔除<img src="/Image1/d2/d2da76bc41a1fb809220fa262acccabc.jpg" />和<img src="/Image1/1c/1c763555bf398c38adeb12fd5cb9b399.jpg" /><br>C:拔除<img src="/Image1/52/5263c2f8ce9ec8aef1b46b187402e12e.jpg" />和<img src="/Image1/1c/1c763555bf398c38adeb12fd5cb9b399.jpg" /><br>D:拔除四个第一前磨牙<br>E:不拔牙