Clinical form
KYT Framework Clinical Evaluation Form
Threshold Worksheet
This form is for clinicians. Patients: see the Patient Evaluation Form.
Use this worksheet to evaluate whether Structure, Force, Time, and Stability are converging toward a treatment threshold. The goal is not to justify treatment. The goal is to identify timing.
1. Structure Assessment
- Remaining coronal tooth structure adequate for proposed restoration.
- Cuspal thickness sufficient under expected occlusal load.
- Marginal ridges intact, compromised, or absent.
- Crack lines present, symptomatic, stained, or extending subgingivally.
- Existing restoration size, depth, leakage, recurrent decay, and undermined enamel assessed.
2. Force Assessment
- Occlusal load evaluated in centric and excursive movements.
- Parafunction noted: bruxism, clenching, wear facets, fremitus, mobility, or fractured restorations.
- Lateral force risk assessed, especially on posterior teeth and restored cusps.
- Opposing dentition, implant restorations, appliances, and missing posterior support considered.
- Night guard, occlusal adjustment, or force management indicated if needed.
3. Time Assessment
- Condition compared with prior exams, radiographs, photos, or symptoms when available.
- Progression pattern identified: stable, slowly changing, active, or uncertain.
- Restoration age and failure pattern considered.
- Pulpal history reviewed: reversible symptoms, lingering symptoms, spontaneous pain, prior endodontic treatment.
- Periodontal and bone support trajectory assessed.
4. Long-Term Stability Projection
- Five-to-ten-year prognosis estimated for each reasonable option.
- Restoration pathway considered: filling, onlay, crown, endodontic treatment, extraction, implant, bridge, or monitoring.
- Remaining reserve after treatment estimated.
- Maintenance risk discussed: hygiene access, recurrent decay risk, occlusal risk, periodontal risk, and patient factors.
- System-level effect considered, including adjacent teeth, opposing teeth, and overall bite stability.
5. Threshold Convergence
- Structure risk alone sufficient or insufficient to justify treatment.
- Force risk modifies urgency or changes treatment design.
- Time shows stability, progression, or loss of reserve.
- Long-term stability favors monitoring, intervention, staged treatment, or replacement.
- Final threshold category recorded: below threshold, at threshold, above threshold, or uncertain with defined review interval.