Saving teeth and true treatment endpoints in an implant world.

A thought on the importance of saving teeth as much as possible and on the true dental treatment endpoints in the modern world where it’s a universally common practice to extract teeth and replace them with implants even when they can actually function for a long time. Clinicians must be aware of patient expectations when planning dental treatment. When full mouth reconstruction is planned, it is very important to satisfy such expectations in order to provide successful treatment. Patients are often concerned about the cost and duration of treatment, and the pain, esthetics, comfort, and function after treatment. However, we cannot assure longevity unless the treatment has a scientific basis. During reconstruction or restoration, we generally remove and replace the existing crowns. Secondary caries are mostly detected on removal of these. Due to the caries, the ferrule and tooth thickness are not adequate; and frequently, the condition may not be suitable for prosthetic treatment.

In such cases, we choose to extract the tooth or perform crown lengthening to retain the tooth.These days many teeth that we could retain by crown lengthening procedure are replaced by implants. We describe some cases in which a crown lengthening procedure had to be performed in anterior and posterior areas to retain the teeth, followed by soft tissue management and final esthetic restoration. The treatment plan, procedure, progress and results are presented here. On the other hand, unfortunately there are many teeth that can’t be retained. It goes without saying that Implant therapy is necessary to keep a long-term good oral condition with esthetically and functional. When we need Implant therapy, how should we use? In order to make the natural oral condition , reconstruction of soft and hard tissue is needed. We describe some cases with implant therapy. And after patients and clinicians satisfy the esthetic, functional and very natural results, when and what condition of the true treatment endpoint patients should be reached. After we reach the true treatment endpoint. patients should be shifted into the maintenance stage.