The Fractured Endodontically Treated Maxillary Anterior Tooth: Restore or Replace?

The compromised maxillary anterior tooth can present an extremely challenging situation for a dentist, who is often faced with the decision to either restore the tooth or extract it. This critical decision must be made in a timely fashion and be based on set criteria and scientific research. Often, however, it comes down to the dentist's clinical experience and the patient's demands. This article provides basic, straightforward criteria for clinicians to follow when making this difficult decision. It describes how such factors as prognosis, cost, smile line, amount of tooth structure, and phenotype influence this decision, and discusses restorative options. A flowchart the restorative dentist can utilize in the decision-making process is provided. The clinician's ultimate goal is to deliver to the patient the most predictable and long-lasting restoration possible, one that satisfies functional and esthetic requirements and meets the patient's desires.