A commentary on strategic extraction

Background: Advancements in strategies to maintain compromised teeth combined with a greater understanding of risks associated with dental implants invite a reassessment of the benefits of strategic extraction of a tooth with a questionable prognosis or of limited strategic value. Methods: Evidence of the management of compromised teeth and decision making for strategic extraction was reviewed. Additionally, the risks for peri-implantitis were evaluated from the perspective of patient centric, biologic, and biomechanical complications. Results: Recent clinical innovations support a more predictable maintenance of compromised dentition, and the clinical literature provides evidence of the risks associated with dental implants. Conclusions: Because of the improvements in dental management of compromised dentition, strategic extraction should be deferred, whenever possible, to avoid complications associated with peri-implantitis.