Avoiding "the space" by the treatment of compromised teeth

The advent of implant therapy has given new a dimension to dentistry particularly where teeth have been irretrievably damaged or pathologically involved. There are many situations however, where endodontic or combined therapy may effectively retain compromised teeth and clinicians should carefully evaluate evidence-based treatment. The main areas discussed are: transverse and crown root fractures and invasive cervical resorption. Transverse root fractures have an excellent natural healing capacity and will also respond favourably to treatment if pulp necrosis occurs in the coronal segment. Studies have shown that crown root fractures can be effectively treated by combined endodontic-orthodontic-periodontic and prosthodontic therapy. Invasive cervical resorption has been classified into four classes depending on the degree of infiltration of resorptive tissue into the tooth structure. A study of treatment results following the topical application of 90% aqueous trichloracetic acid, curettage and restoration indicated that this regimen could be successfully applied to Classes 1, 2 and 3 resorption.