Rebuilding Strength and Sustainability: A Contemporary Prostho-Endo Paradigm for Managing Structurally Compromised Teeth

Introduction: Managing structurally compromised teeth remains a multifaceted challenge in modern dental practice, requiring a coordinated interdisciplinary approach that integrates prosthodontic and endodontic principles to achieve optimal functional and aesthetic rehabilitation. Objective: This narrative review critically evaluates contemporary evidence-based protocols for restoring structurally compromised teeth, emphasizing the synergistic role of prosthodontic and endodontic strategies. Literature Review: Structurally compromised teeth exhibit reduced biomechanical integrity, increasing the complexity of restorative procedures and jeopardizing long-term prognosis. Achieving durable outcomes necessitates a treatment philosophy that balances preservation of remaining tooth structure, aesthetic demands, and biomechanical requirements. An interdisciplinary prostho-endo approach—incorporating advanced adhesive dentistry, biologically oriented preparation techniques, surgical crown lengthening when needed, and modern prosthodontic restorations—enhances predictability and improves long-term survival of compromised teeth. Conclusion: Early interdisciplinary collaboration is fundamental to optimizing tooth longevity, function, and aesthetics. A prostho-endo workflow rooted in minimally invasive, evidence-based principles aligns with contemporary expectations for patient-centered dental care.