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Shane Lowry and England's Tom Lewis finished a shot outside the play-off, Lewis charging through the field with a 64 and Lowry carding a closing 68 at the Alfred Dunhill Links.
The Clara golfer had briefly led by two shots after playing his first 11 holes in six under par, but paid the price for dropped shots at the 13th and 15th.
Lowry, who defends his Portugal Masters title in a fortnight’s time, was six under par for his round thanks to an eagle at the par four tenth and four birdies.
He was one ahead of England’s David Howell, who had five birdies in six holes from the second as he chases a first European Tour win for seven years.
Lowry's lead was briefly two shots when Howell three-putted the 12th, but Lowry then bogeyed the 13th in the group ahead after failing to get up and down from short of the green.
That meant Lewis was just one shot off the lead at 22 under and the 22 year old had the chance to set a testing clubhouse target with just two holes to play.
Lewis duly parred the last two holes to complete a flawless 64 and set the clubhouse target at 22 under - a superb effort which should at least secure his card for next season even if not enough to win the event.
A bogey from Lowry on the 15th - where he missed from inside three feet after an excellent chip from short of the green - left Uihlein out in front on 23 under with four holes to play.
So it England's David Howell claimed his first European Tour title in seven years on Sunday by beating American Peter Uihlein in a sudden-death play-off at the Alfred Dunhill Links Championship.
Howell carded a final round of 67 to set the clubhouse target and then watched as overnight leader Uihlein missed from 15 feet for a winning birdie on the 18th, meaning the pair finished tied on 23 under par.
Both players narrowly missed long birdie attempts on the first extra hole, meaning action switched from the first to the 18th.
Uihlein left his birdie putt from long range inches short but Howell, who had lost all four of his previous play-offs, made no such mistake from eight feet to claim the title and first prize of £495,000.
"It's incredible, the sun is shining and the crowd have come out," Howell said. "I have never played in an Open Championship here but to win a golf tournament as a professional at the Home of Golf is quite amazing and I am really thrilled.
"I was really nervous all week and strangely less nervous today, I can't explain that at all. I stayed calm and smooth under pressure and that was really pleasing.
"It's been a long, long road from the depths of despair. I have had a lot of support from people around me and this is as much for them as it is for me."
Lewis began the week 155th on the European Tour's Race to Dubai with only the top 110 in three weeks' time keeping their card for next season, but the share of third place will be enough for the 22-year-old to retain his playing rights.
Lowry had briefly led by two shots after playing his first 11 holes in six under par, but paid the price for dropped shots at the 13th and 15th.