This is taken from a forthcoming article to be published by Khademi, Clark and Kim
It's pretty much the way I have been practising for 15 years, smaller shapes and access made possible with new instruments and proper microscope use, to preserve vital tooth tissue and retain teeth for longer. Sometimes even doing nothing is the right thing to do!
We should accept a reasonable but limited
life expectancy for any treatment, and weigh such expectancy relative to the
invasiveness of the treatment and remaining options for future revision. Simply, our
treatment planning should have context. For instance, what is our confidence that an
implant restoration will last a lifetime in a 30 year old versus a 60 year old? Astute
clinicians are becoming increasingly aware of implant longevity and complications. The
pendulum is swinging back towards preservation and restoration of the natural tooth.
We need a shift in our professional expectations and modus operadi. Our patients’ life
expectancies are much longer, and our professional care for them will be a marathon.
We believe that this entails a focus on preservation of tooth structure, rather than
accelerating options towards terminal treatment.