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| CE article treatment planning 06 roots 3 2016 Treatment planning: Retention of the natural dentition and the replacement of missing teeth Author: Dr Scott L. Doyle, USA Introduction Preservationofthenaturaldentitionistheprimary goalofdentistry.Publishedsurveysindicatethatpa- tients generally value teeth and express a desire to save their natural dentition in favour of extraction whenever possible.1, 2 Significant technological and biological improvements have been made in all disci- plines of dentistry, making long-term retention of naturalteethmoreattainable.Patientsentrustdental professionalstomakeappropriaterecommendations regarding the maintenance and restoration of their oral health and function. It is essential to employ an evidence-based, interdisciplinary approach that ad- dressestheinterestsofthepatientwhendetermining the best possible course of treatment. In July 2014, the American Association of Endo- dontists, in collaboration with the American Col- legeofProsthodontistsandtheAmericanAcademy of Periodontology, hosted a two-day Joint Sympo- sium titled Teeth for a Lifetime: Interdisciplinary Evidence for Clinical Success. Approximately 375 general dentists and specialists assembled in Chi- cago to focus on preserving the natural dentition. The educational program included evidence-based presentations on advanced regenerative tech- niques, improvements in technology, minimally invasive restorative methods and best practices for interdisciplinary treatment planning. Dr Alan Gluskin, chair of the 2014 Joint Symposium Plan- ning Committee, concluded that the current evi- dence directs clinicians to consider saving the nat- ural dentition as the first option when developing treatment plans. Dental implants are one of the most significant advancements in contemporary dentistry. This in- novation has had profound effects on endodontic, periodontic and prosthodontic treatment plan- ning for the rehabilitation of edentulous spaces and for teeth with an unfavorable prognosis.3 Im- plant-supported restorations minimize unneces- sary preparation of intact abutment teeth and allow fixed prosthodontic replacement when suit- able abutments are absent. With appropriate us- age and case selection, implant dentistry provides a viable option for the replacement of missing teeth.4, 5 There has been an increasing trend toward re- placing diseased teeth with dental implants. Often, aninadequateorinappropriateindicationfortooth extraction has resulted in the removal of teeth that mayhavebeensalvageable.6 Teethcompromisedby pulpalorperiodontaldiseasehavevalueandshould notbeextractedwithoutthoroughlyevaluatingre- storability and potential retention therapies.7 CE credit This article qualifies for CE credit. To take the CE quiz,log on to www. dtstudyclub.com. Click on ‘CE arti- cles’ and search for this edition of roots magazine. If you are not reg- istered with the site, you will be asked to do so before taking the quiz.You may also access the quiz by using the QR code above. Fig.1a 32016