Saving natural teeth, whenever possible, is the best option. Nothing artificial can replace the look or function of a natural tooth. If both the tooth and surrounding structures (i.e. the gum and bone) are healthy, root canal treatment can be performed. Root canal treatment has a high success rate and under appropriate care, teeth that have undergone root canal treatment can last a long time.
Root canal procedure can often be carried out in one visit whereas an implant replacement may require multiple visits. For front teeth, the final aesthetic result is always a big issue. It is easier to achieve good aesthetic results with natural teeth than with implants. In some cases, the metal of implants may show through the gum which can be difficult to rectify.
When root canal is not possible, implant replacement is also a possible option. This is primarily advocated when the tooth and/or surrounding structures are unhealthy or compromised. Examples include a tooth with a fractured root, a tooth that is badly decayed, or a tooth that is surrounded by infected gums and bone. In such cases, an implant may be a better choice.