This one is interesting. This patient winds up in our office for a 3rd opinion because the tooth had been condemned for extraction. After careful discussion with both patient and restorative dentist, we were able to identify that the resorption process was still above the level of the bone. Osseous crown lengthening was discussed as a potential requirement for an adequate restoration. We were able to completely degranulate the resorption tissue using the endodontic microscope, treat the area with acid, and repair with defect from within the endodontic access. Additionally, we placed a fiber reinforced post so that the restorative dentist didn’t have to deal with the isolation issues. We feel confident that this is a very viable alternative to extraction and a dental implant. Because we also do dental implants in our office, we were able to have a competent treatment discussion with regards to both options and their prognosis prior to choosing one that was appropriate for this patient.