The main goal in dentistry is to preserve teeth and adjacent structures. When a tooth is lost, its rehabilitation evolves fixed, removal or a combination of both prosthodontic modalities.With the phenomenon of osseointegration the endosseous implants came to add another tool to prosthodontic solutions. Not only it came to rehabilitate edentulous ridges but also it arouses the discussion about when to keep compromised teeth. The discussion between Implants Vs Endodontic treatments has traditionally been reduced to the debate around success and survival rates of each modality. Nowadays we know that despite of both being use as abutments for a future restoration they also share important differences.The goal of this literature review is to enhance the differences, advantages and disadvantages of each one in the aesthetic area.The second part of this work will present a classification system to help in the correct decision.