Glossary

Published definitions for the canonical doctrine. Terms are written for threshold-based clinical decision-making.

Structural Decision Framework™ (SDF)

A threshold-based clinical decision model in dentistry that evaluates irreversible treatment through four integrated variables: structure, force, time, and long-term stability.

The Structural Decision Framework™ formalizes the boundary at which preservation ends and escalation becomes structurally justified.

Structure

The remaining physical integrity and geometric stability of a tooth and its supporting apparatus.

Structural assessment includes:

• Enamel thickness
• Dentin volume
• Marginal ridge integrity
• Cuspal configuration
• Crack presence and orientation
• Root morphology
• Periodontal support

Structure defines capacity.

Force

Functional and parafunctional load applied to structure.

Force is evaluated through:

• Magnitude
• Direction (axial versus lateral)
• Frequency
• Duration
• Distribution across the arch
• Parafunctional modifiers (e.g., bruxism, clenching)

Parafunction acts as a force multiplier.

Force defines demand.

Time

The variable of cumulative exposure and progression velocity.

Time incorporates:

• Biological progression (caries, periodontal change)
• Fatigue accumulation under cyclic loading
• Restorative material aging
• Behavioral modifiers and compliance

Time defines exposure.

Long-Term Stability

The projected predictability of structural durability after preservation or intervention.

Long-term stability evaluates:

• Fracture probability
• Restoration longevity
• Risk of re-intervention
• Predictability of replacement pathway if failure occurs

Long-term stability defines projected outcome.

Structural Reserve

The finite load-bearing capacity of a tooth beyond current demand. Structural reserve decreases with each irreversible intervention. Every preparation, reduction, or access is a permanent withdrawal.

Structural reserve determines tolerance under projected force across projected time.

Threshold

The relational boundary between preservation and escalation.

Threshold is reached when projected force across projected time exceeds remaining structural capacity and reduces long-term stability below acceptable predictability.

Threshold is individualized and variable-dependent.

Threshold Convergence

The condition in which structure, force, time, and long-term stability align toward inevitable instability. Convergence provides clinical justification for irreversible intervention.

Irreversible Treatment (Escalation)

Any clinical intervention that permanently removes, alters, or replaces biological architecture.

Examples include:

• Class II composites
• Cuspal coverage restorations (crowns)
• Endodontic therapy
• Extraction
• Implant placement

Non-examples include:

• Monitoring
• Hygiene therapy
• Occlusal guards
• Dietary counseling

Premature Escalation (Acting Too Soon)

Irreversible treatment performed before threshold convergence. Premature escalation consumes structural reserve without improving projected long-term stability.

Delayed Escalation (Acting Too Late)

Failure to intervene after threshold convergence has occurred. Delayed escalation allows instability to compound and typically results in more severe structural failure.

The Deceptive Interval

The period between an irreversible intervention and its eventual structural failure. During this interval, the tooth may remain asymptomatic and radiographically acceptable, providing false validation of a threshold miscalculation.

Optionality

The range of viable future structural pathways remaining before threshold convergence.

High structural reserve preserves optionality. Escalation narrows optionality.

Velocity of Change

The rate at which a structural defect progresses.

Monitoring is justified only when velocity of change remains low. High velocity indicates accelerating convergence toward threshold.

Bite Instability (System-Level Convergence)

A system-level condition in which force distribution across the dentition produces progressive structural degradation over projected time. Bite instability reflects convergence across multiple teeth rather than isolated pathology.

Replacement Instability

Progressive decline in long-term stability within a replacement pathway. Each successive restoration reduces structural reserve and often shortens intervals of durability, producing accelerated structural loss. Replacement instability signals the need for system-level threshold reassessment.