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The options for a tooth that requires root canal treatment

From Volume 45, Issue 3, March 2018 | Pages 182-195

Authors

Shiyana Eliyas

BDS, MFDS, MRD, FDS(Rest Dent), PhD

Specialist Registrar in Restorative Dentistry, Sheffield Teaching Hospital, Sheffield

Articles by Shiyana Eliyas

Peter Briggs

BS(Hons), MSc, MRD RCS(Eng), FDS RCS(Eng)

Consultant, Restorative Department, GKT Dental Institute and St George's Hospital, London

Articles by Peter Briggs

Jennifer E Gallagher

MBE, PhD, MSc, DCDP, BDS, FDS RCS(Eng), DDPH RCS(Eng), FHEA

Senior Lecturer/Honorary Consultant in Dental Public Health, King's College London Dental Institute at Guy's, King's College and St Thomas' Hospitals, Department of Oral Health Services Research and Dental Public Health, Oral Health Workforce and Education Research Group, London, UK

Articles by Jennifer E Gallagher

Abstract

Abstract: There have been many advances in the replacement of teeth, especially using dental implants. There are a number of other options for when a tooth is lost; however, there is also value in maintaining a tooth with the provision of root canal treatment and a good coronal seal. This article summarizes the advantages and disadvantages of each option with supporting evidence from the literature.

CPD/Clinical Relevance: This review article provides an updated practical perspective to decision-making when it comes to teeth requiring root canal treatment.

Article

In this age of increasing emphasis on body image and youthful appearance, the perfect white smile is fast becoming a norm by which people are judged.1,2,3 This may influence the retention of natural teeth, however, there is a possibility that the natural tooth is being replaced when complex restorative dental treatment is required, possibly in order to achieve the ideal appearance more easily. When the public and some of the profession consider implants a panacea, what are the options for a tooth that requires root canal treatment? Is there a place for providing dentistry to retain a natural tooth?

The effect of tooth loss on a person's quality of life has been investigated in several studies,4,5,6,7,89 with a general consensus that tooth loss had a negative impact on quality of life, and patients citing reduction in chewing ability following the loss of teeth as a cause. However, the prospect of tooth loss is less dramatic in recent times because of the variety of options available for filling the space or spaces. With the reported success rates of implants, there is a possible departure towards replacing teeth with implants if complex restorative work is required to maintain the tooth in situ. A number of articles have described the virtues of maintaining a natural tooth in relation to accepting a space or providing a prosthetic replacement.10,11,1213,14,15,16

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