The objective of this nonsystematic review of the literature is to determine whether or not self-ligating brackets are an equally effective alternative to traditional brackets for non-extraction treatments. The agreed upon criteria are indications for extractions, the biomechanical approach, the stability of the treatment results, the iatrogenic effects and the ergonomics.

The studies discuss arch expansion with the use of self-ligating brackets. One study mentions a lack of control of osseous management including tipping and buccal bone thickness in the lateral sectors. The mandibular incisor inclination that was obtained does not appear to be correlated to the type of bracket but rather to initial factors specific to the patient. We didn’t find any study dealing with the long-term stability of the results.

Regarding patients, self-ligating brackets do not reduce the pain, the number of extractions, the incidence of resorption or the risk for caries. Self-ligating brackets shortened the clinical time for an experienced practitioner but not the length of the time of comprehensive treatment and alignment. Some studies report an increase in cases of emergency. Finally, these brackets are more difficult to position.

Orthodontists frequently prescribe prophylactic enucleation of the lower third molars. These teeth are mostly totally asymptomatic. This practice is being recommended more and more frequently, even though published studies are more reserved in this respect. Orthodontists have to reconsider their recommendations for prophylactic enucleation of the lower third molars, but they have to make sure whether or not these teeth will erupt into their correct positions in the arch.

Indications for the extraction of permanent healthy teeth in dentofacial orthopedics, has been an object of polarized debate between extractionists and nonextractionist since the beginning of the twentieth century.

In a media-hyped environment, where extractions have become routine, this concern that is not addressed during consultation, poses a problem for the patient-practitioner relationship. The practitioner is confronted with a criminal liability known as a failure to respect the physical integrity of the human body and to treat in the patient's best interest. But the question remains: is it ethical to extract healthy teeth?

Our study among an orthodontic population of 1,095 patients indicates that 9% of the subjects have at least one agenesis (3% for maxillary lateral or mandibular central/lateral incisors).

Regarding possible treatments, we evaluated the different solutions from the less invasive to the most invasive: simple space closure, space closure with laminated veneers, space opening with a cantilevered bonded bridge, space opening with implant.

Recent advances in biomimetic dentistry suggest that now is the time for a paradigm shift.

With the development of so-called “non-extraction”10 treatments in contemporary orthodontics, complications in the eruption of the second molars are becoming noticeably more prevalent in our practices ranging from a simple delay of eruption, to ectopic eruption, up to retention of the second molars caused by a mechanical obstruction. Using a retrospective study of some cases and a review of the literature, we are seeking to find new diagnostic approaches in order to choose the best treatment.