Should retention of a tooth be an important goal of dentistry? How do you decide whether to retain and restore a tooth requiring endodontic treatment or to extract and if possible replace the tooth?

Whether a questionable tooth should be treated endodontically or extracted, is still a dilemma clinicians encounter every day. With advances in technology such as implantology, deciding whether or not to save a tooth is still not clear. Local site-specific factors and patient-related factors that may affect the longevity of a particular tooth should be considered in preparing the treatment plan. Long-term success rates for root canal therapy and implant-supported crowns demonstrate similar outcomes. A choice between these alone is not sufficient in the decision-making process. Only following a systematic evaluation of the reasons for and against tooth retention as directed by each individual case, can the best option be decided.