The decision to extract or maintain compromised teeth with periodontal–endodontic lesions is complex while taking into consideration the endodontic, periodontal, and reconstructive aspects of these teeth. Extraction of teeth with untreatable periodontal–endodontic lesions having severe alveolar bone damage can lead to difficulty in their surgical management. Several treatment approaches are available following the extraction of compromised teeth with an intact facial wall of the alveolar socket.