Introduction - An essential goal of an orthodontic treatment is to attain a normal relationship of the teeth and their surrounding soft tissue structures. Retaining all the teeth requires a satisfactory balance towards total tooth material and the available supporting bone. Conventional extractions of first or second premolars are sometimes not able to fulfill the objectives required in such cases. Therefore, atypical extractions of other teeth is carried out.
Material and method - A comprehensive literature from orthodontic relevant sources and information was searched with the help of Pubmed, Medline, Google scholar, Scopus using keywords like atypical, asymmetric extractions.
Results - In borderline cases, compensatory orthodontic treatment may be a viable option, since the esthetic balancing of the face is not always the major motive for treatment.
Conclusion - Proper treatment planning in conjunction with good patient cooperation, appliance selection and management of the treatment are essential to achieve acceptable, aesthetic and functional occlusion.