title: A novel decision-making process for tooth retention or extraction.
abstract: BACKGROUND
  Implant-supported restorations have become the most popular therapeutic option for professionals and patients for the treatment of total and partial edentulism. When implants are placed in an ideal position, with adequate prosthetic loading and proper maintenance, they can have success rates >90% over 15 years of function. Implants may be considered a better therapeutic alternative than performing more extensive conservative procedures in an attempt to save or maintain a compromised tooth. Inadequate indication for tooth extraction has resulted in the sacrifice of many sound savable teeth. This article presents a chart that can assist clinicians in making the right decision when they are deciding which route to take.
  
  
  METHODS
  Articles published in peer-reviewed English journals were selected using several scientific databases and subsequently reviewed. Book sources were also searched. Individual tooth- and patient-related features were thoroughly analyzed, particularly when determining if a tooth should be indicated for extraction.
  
  
  RESULTS
  A color-based decision-making chart with six different levels, including several factors, was developed based upon available scientific literature. The rationale for including these factors is provided, and its interpretation is justified with literature support.
  
  
  CONCLUSIONS
  The decision-making chart provided may serve as a reference guide for dentists when making the decision to save or extract a compromised tooth.
authors.affiliation: Graduate Periodontics, School of Dentistry, University of Michigan, Ann Arbor, MI 48109-1078, USA.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Avila
authors.forename: Pablo
authors.initials: P
authors.lastname: Galindo-Moreno
authors.forename: Stephen
authors.initials: S
authors.lastname: Soehren
authors.forename: Carl E
authors.initials: CE
authors.lastname: Misch
authors.forename: Thiago
authors.initials: T
authors.lastname: Morelli
authors.forename: Hom-Lay
authors.initials: HL
authors.lastname: Wang
mesh_terms: D016301:Alveolar Bone Loss / Q000145:classification; D001294:Attitude to Health; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D019992:Databases as Topic; D003657:Decision Making; D003661:Decision Support Techniques; D003663:Decision Trees; D003728:Dental Calculus / Q000150:complications; D003731:Dental Caries / Q000150:complications; D003793:Dental Restoration, Permanent / Q000191:economics / Q000523:psychology; D004955:Esthetics, Dental; D017823:Furcation Defects / Q000145:classification / Q000175:diagnosis / Q000209:etiology; D006304:Health Status; D006801:Humans; D019647:Oral Surgical Procedures; D010349:Patient Compliance; D010508:Periodontal Abscess / Q000145:classification; D010510:Periodontal Diseases / Q000145:classification / Q000175:diagnosis / Q000209:etiology; D010514:Periodontal Pocket / Q000145:classification; D011176:Post and Core Technique; D019233:Retreatment; D012196:Review Literature as Topic; D012390:Root Canal Therapy; D012907:Smoking; D014076:Tooth Diseases / Q000191:economics / Q000523:psychology / Q000628:therapy*; D014081:Tooth Extraction; D014086:Tooth Mobility / Q000145:classification; D014092:Tooth Root / Q000002:abnormalities / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents