Implant Dentistry has evolved dramatically since it’s inception as an anchor for the fully edentulous patient population. Today, more than ever, implants are being utilized for the partially edentulous patient as segmental or single tooth replacements where long term function and esthetics are of prominent importance. The dental implant specialist must therefore attempt to work backwards from the restorative-esthetic final goal of therapy to the beginning of the case where the initial decisions are being made. Restorative driven implant based decision making by the surgeon will lead to the correct augmentation and implant selection for the specific needs of the patient. This “reverse pathway” approach is the protocol featured in this article to achieve excellent results and avoid complications.