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A novel decision-making process for tooth retention or extraction
Journal article   Open access   Peer reviewed

A novel decision-making process for tooth retention or extraction

Gustavo Avila, Pablo Galindo-Moreno, Stephen Soehren, Carl E Misch, Thiago Morelli and Hom-Lay Wang
Journal of periodontology (1970), Vol.80(3), pp.476-491
03/2009
DOI: 10.1902/jop.2009.080454
PMID: 19254132

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Abstract

Implant-supported restorations have become the most popular therapeutic option for professionals and patients for the treatment of total and partial edentulism. When implants are placed in an ideal position, with adequate prosthetic loading and proper maintenance, they can have success rates >90% over 15 years of function. Implants may be considered a better therapeutic alternative than performing more extensive conservative procedures in an attempt to save or maintain a compromised tooth. Inadequate indication for tooth extraction has resulted in the sacrifice of many sound savable teeth. This article presents a chart that can assist clinicians in making the right decision when they are deciding which route to take. Articles published in peer-reviewed English journals were selected using several scientific databases and subsequently reviewed. Book sources were also searched. Individual tooth- and patient-related features were thoroughly analyzed, particularly when determining if a tooth should be indicated for extraction. A color-based decision-making chart with six different levels, including several factors, was developed based upon available scientific literature. The rationale for including these factors is provided, and its interpretation is justified with literature support. The decision-making chart provided may serve as a reference guide for dentists when making the decision to save or extract a compromised tooth.
 Humans Alveolar Bone Loss - classification Oral Surgical Procedures Tooth Mobility - classification Review Literature as Topic Dental Caries - complications Tooth Extraction Tooth Root - surgery Tooth Root - abnormalities Dental Restoration, Permanent - psychology Tooth Diseases - psychology Periodontal Diseases - classification Periodontal Abscess - classification Decision Making Tooth Diseases - economics Periodontal Diseases - etiology Root Canal Therapy Tooth Diseases - therapy Attitude to Health Periodontal Diseases - diagnosis Decision Support Techniques Bone Density Conservation Agents - therapeutic use Treatment Outcome Furcation Defects - diagnosis Periodontal Pocket - classification Databases as Topic Esthetics, Dental Retreatment Furcation Defects - etiology Post and Core Technique Dental Restoration, Permanent - economics Dental Calculus - complications Decision Trees Patient Compliance Health Status Furcation Defects - classification Smoking

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