Hi Liviu,

I'm not an expert of occlusion but from my point view, the most important criteria is the loss tooth structure assesment. Such contemporary approaches should focus on preservation of the vital tooth whenever possible with adhesive dentistry. The same way of thinking is required regarding endodontically treated teeth. Thus, treatment planning for a nonvital tooth depends on the amount of tooth structure lost, its location, and tooth placement on the arch. Therefore, the crown should not be systematic. In this context, occlusion is a crucial parameter which influences the decision making process. For instance, Bruxism and dysfunctions are some well-known risk factors. In these cases, the cuspal coverage should be indicated to avoid fractures. The kind of tooth (anterior or posterior) is also an important parameter because the biomechanical behavior is different according to the location on the arch (flexion for anterior and compression for posterior...). Moreover, we have to take care not to change the occlusal concept of the patient if the latter is well tolerated and if only one or a a few restorations are necessary. At the opposite, a global rehabilitation could lead to wide occlusal concept changes.

Hello Frederik,

excellent suggested approach which I compliment with some additional criterias:

1. remaining tooth structure;

2. quality of remaining tooth structure;

3. topography of remaing tooth structure;

4. tooth position in the jaw and it s function;

5. available occlusal concept;

6. available CMD;

7. etc.

Very nice way you have approached the topic.

BTW. this are decissive criterias for the dilemma:

to save or to extract!