Tooth preservation, implants and surgery in complex rehabilitation
Decisions start with prognosis and the possibility of a maintainable restoration.
On this page
Can the tooth be retained?
Assessment considers remaining tooth tissue, periodontal support, cracks and the feasibility of root canal treatment. A treatable root canal does not guarantee a durably restorable tooth. Endodontic and restorative prognosis need to be considered together. [1]
What do implants contribute?
The implant is the component placed in bone; the crown or prosthesis it supports is the prosthetic restoration. Both require coordinated planning. An implant is not compulsory for every missing tooth and does not automatically justify extraction.
When is surgery discussed?
Diagnosis may indicate extraction, periodontal surgery or tissue augmentation before implant placement. EFP guidance calls for assessment of surgical contraindications, available tissues and peri-implant risks. Additional procedures are not necessary in every case. [2]
How are options compared?
Ask about appropriate tooth-supported, implant-supported or removable options. Discuss procedures, maintenance and what a complication would mean. Your preferences matter alongside technical feasibility.
Clinical sources
- American Association of Endodontists. Fundamentals of Restorability. 2021.
- EFP. Treatment of stage IV periodontitis — Cases 3 and 4. Companion infographic to the 2022 guideline.
Further reading
- 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.