Complex rehabilitation: building an interdisciplinary plan
Prosthodontics, endodontics, periodontics, implant dentistry, orthodontics and surgery coordinated around diagnosis.
On this page
What makes a case complex?
Missing teeth, failing restorations, periodontal problems, wear and difficult tooth positions may coexist. Complexity is not simply the number of crowns. A plan should address the diagnosed problems with clear goals and stages.
Who contributes?
Prosthodontics plans restorations. Endodontics assesses the dental pulp and tissues around root tips. Periodontics addresses supporting tissues. Orthodontics can change tooth position; implant dentistry and surgery contribute where indicated. Not every patient needs every discipline.
Why does sequencing matter?
The EFP guideline recommends multidisciplinary care for stage IV periodontitis. Disease control and tooth prognosis influence definitive restoration. Likewise, the coronal restoration following root canal treatment belongs in the plan and should not be unnecessarily delayed. [1] [2]
What should the plan explain?
Priorities, alternatives, proposed procedures and reassessment points. Ask who coordinates the case and what might alter the estimated time or cost. Some decisions can only be confirmed after the response to initial treatment.
Clinical sources
- Herrera D et al. Treatment of stage IV periodontitis: The EFP S3 level clinical practice guideline. 2022.
- American Association of Endodontists. Treatment Standards: Executive Summary. 2019.
Further reading
- Torabinejad M, Fouad AF, Shabahang S. Endodontics: Principles and Practice. 6th ed. Elsevier, 2021.
- Rosenstiel SF, Land MF, Walter R. Contemporary Fixed Prosthodontics. 6th ed. Elsevier, 2023.
- Misch CE. Dental Implant Prosthetics. 2nd ed. Mosby, 2015.
Selected editions published from 2012 onwards. Books are recommended for further reading; clinical explanations reference the accessible sources above.
The information on this page is general and educational. It does not replace a medical consultation, and a treatment recommendation can only be made after examining each patient. Results differ from one case to another.
A plan for your situation
Book a consultationStart with a consultation and a plan
Every treatment begins with a diagnosis: clinical examination, photographs, radiographs and, where relevant, an occlusal analysis. Only then do we discuss options.