[Therapeutic choices and prognosis related to teeth or implants]

Preservation of natural teeth is the ultimate goal of dentistry today. Regular screening for periodontal disease, followed by infection control whenever necessary, positively affects tooth preservation, the more when the patients complies with therapy and regular maintenance. The dentist is, however, often confronted with treatment dilemmas and has to decide whether to extract or preserve teeth, to extirpate or extract, to keep or to implant, to make removable or fixed prostheses. Decision making is depending on the prognosis of teeth and becomes more difficult when teeth are supporting prosthetic restorations because the question arises: "How long will the teeth and the restoration survive?". Systematic reviews have revealed that teeth and implants have a similar prognosis. They are prone to biological and technical complications, the latter determining long term prognosis. Implant survival rates are around 93% after 10 years but the survival of the construction ranges between 80% and 90% depending on the type and extension. Complications are reported in the order of 35%. Prosthetic restoration on natural teeth have a 10-year survival of 80-90% with 34% of complications. The present paper gives a brief overview of the prognosis of dental treatments and discusses arguments that may be of help to make treatment decision choices.