In our cultural pattern shortened dental arches are frequently seen, as molars are often seriously afflicted by caries and periodontal disease. The necessary restorative treatment is often omitted because of lack of motivation andlor financial limitations.Clinical investigations among subjects with shortened dental arches show that there is sufficient adaptive capacity to maintain adequate oral function when at least four occlusal units are left, preferably in a symmetrical position.Treatment by providing free-end removable partial dentures introduces unfavourable conditions for the remaining dentition. Overtreatment with these appliances is caused by traditional mechanically and morphologically oriented occlusal concepts, disregard of the adaptive capacity in biologic systems, and quantity promoting fee schedules. Problem solving approaches in occlusal therapy should be stimulated to prevent overtreatment.

The distance measured from a constant reference to the subgingival cemento-enamel junction by four observers with two different probes in 11 patients was compared to independent precision measurements of the same distance performed during periodontal surgery. The findings question the validity of probe measurements with relation to the cemento-enamel junction.

In this article the motives for, and the characteristics and the structure of the problem-oriented approach in treatment planning are presented. The differences, compared with the traditional, morphologically-oriented approach are shown. The strategy used in the problem-oriented planning is described and demonstrated with a clinical case. Important advantages of this method are the objectivity of treatment planning and the elimination of overtreatment.

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