Purpose:This article presents clinical guidelines for restoring structurally compromised teeth and dentitions to reduce the risk for fatigue-caused failures in connection with prosthetic reconstructions. Materials and Methods:Based on the best scientific evidence available and clinical expertise acquired through experience and practice, biomechanical principles are elucidated from a prosthetic aspect. Results:In prosthetic treatment in the structurally compromised dentition, all efforts need to be focused on protecting the abutments and reconstruction from future fatigue failures. A modified, “therapeutic” occlusion to avoid nonaxial forces may then be prudent. Conclusion:By lending the prosthesis a favorable occlusal design, the nonaxial forces may be markedly reduced, and the teeth, cement, and restorative materials will be less susceptible to fatigue failures. Int J Prosthodont 2004;17:135–141.