Is orthodontic treatment without premolar extractions always non-extraction treatment?

While it is common in contemporary orthodontic and orthopaedic treatment to commence treatment for many growing patients during the mixed-dentition, the creation of anterior space, often involving the attempted distalization or holding-back of the upper and lower permanent molar teeth has been shown to commonly result in posterior space deficiencies. Although the extractions of permanent premolar teeth may have been avoided, the developing second and third permanent molars are often affected, so that third molar impaction results in many cases. This is not to say that orthodontic treatment carried-out without premolar extractions is not ideal in many cases, but on the available evidence, so-called absolute 'non-extraction' protocols should be questioned, so that both the dental profession and the public at large are not misled.