Scientific literature has amply demonstrated that the most common cause of tooth extraction is dental fracture, a situation that particularly affects endodontics. We live in the era of minimally invasive dentistry, a concept that should also include endodontics. Ideally, all specialists in preserving teeth should choose philosophies and technology that allow the largest amount of healthy dental tissue to be respected and that lost to be replaced with those materials behaving most similarly to dentine to maintain maximum strength in the problem tooth. But this is not enough. With the increase in the life expectancy of our patients and the rise of implants, we have an even greater responsibility and must focus more on determining a long-term tooth prognosis, centring not only on the possibilities of successful canal treatment, but especially on the viability of the complex considering the individual characteristics of each patient. The aim of this talk is to address this issue by combining the presentation of clinical cases with the available scientific evidence.