Treatment Options for the Compromised Tooth: A Decision Guide
The Decision Guide features different cases where the tooth has been compromised in both nonendodontically treated teeth and previously endodontically treated teeth. Based on the unique individualized features of each case and patient, there are key considerations in establishing a preoperative prognosis of Favorable, Questionable or Unfavorable. The photographs and radiographs in this guide illustrate favorable outcomes for our patients.
If your patient’s condition falls into a category other than Favorable, referral to an endodontist, who has expertise on alternate treatment options that might preserve the natural dentition, is recommended. If the prognosis of the tooth is categorized as Questionable/Unfavorable in multiple areas of evaluation, extraction should be considered after appropriate consultation with a specialist.
In making treatment planning decisions, the clinician also should consider additional factors including local and systemic case-specific issues, economics, the patient’s desires and needs, aesthetics, potential adverse outcomes, ethical factors, history of bisphosphonate use and/or radiation therapy.
Although the treatment planning process is complex and new information is still emerging, it is clear that appropriate treatment must be based on the patient’s best interests.