Evidence-based approach for treatment planning options for the extensively damaged dentition

Restoring the extensively damaged dentition has always been a difficult decision-making process for the dental practitioner. Decisions to restore these teeth were primarily based on the fact that "fixed" teeth are typically better functionally than "removable" teeth and better esthetically than "no" teeth. Prior to dental implants, restoring missing teeth and extensively damaged teeth utilizing traditional therapy such as crown lengthening, root hemisection/amputation, endodontic therapy, apical surgery, post and cores and splinting were the options available to our patients. These teeth typically required the expertise of additional specialist, however their prognosis and success rates were typically guarded at best. Presently, dental implant success rates have been clearly identified and documented in the literature which now questions the survivability and success rates of the traditional mode of therapy for extensively damaged teeth. This paper will attempt to review the dental literature for various traditional modes of therapy for restoring the extensively damaged to provide a consensus of their survivability to help the practitioner to present options and prognosis for their patients.