The purpose of this case is to demonstrate “minimally invasive” tooth access as it pertains to endodontics and subsequent restorative dentistry. Although we can’t really say that having significant decay on the crown of a tooth would classify as “minmally invasive”, there are rarely cases that we come cross that would qualify. In any case, this tooth represents a 5 canaled anatomical presentation. That in itself is pretty …interesting (although also very common). What we have done here is purposefully left a portion of the pulp chamber unroofed (see red arrow). Access to the mesial canals was already straight and accessible and we did not feel the need to enlarge the access in order to remove the pulp tissue from the mesial pulp horns. In order to save healthy tooth strucutre, we used ultrasonic instrumentation (with curved tips) in order to ensure that the pulp tissue was removed from this space. As evidenced in the clinical photo, we are able to conserve as much healthy tooth structure as possible. This makes the restorative dentists VERY happy!