Treating periodontally compromised dentitions has been a challenge to dentists. Periodontal treatments spare no effort in saving teeth but couldn't reach its full extend. In contemporary dentistry, dental implants have been considered an optimal choice when teeth are missing. Survival rate was an important evaluation when dental implants initially developed, whereas success of implant is later considered and become the key to treatment plan. In the dilemma of saving teeth and placing implants, we expect either one to be maintained in function and long-term health. This presentation is to share my clinical experiences and long-term observations in treating periodontally compromised dentitions. The pros and cons of different treatment modalities will be discussed.