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case_images: (A) A photograph depicting the clinical presentation during the initial examination; (B) Diagnostic periapical radiograph image. (Source: personal documentation).
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case_images: Padjadjaran due to a decaying tooth in the lower right back area, which was causing pain when chewing. Prior to this visit, the patient had sought treatment from a general dentist who applied a temporary filling to the afflicted tooth (Figure 5A). However, no abnormalities are observed at the alveolar crest and periapical area (Figure 5B). 
case_images: Axial view of the CBCT examination of tooth 47. (A) Cross-section at the Cementoenamel Junction (CEJ) shows 4 root canal orifices; (B) cervical third shows a continuous C-shaped canal; (C) middle third shows a semicolon shape; (D) apical section shows 2 apical foramina in the mesial root and 1 apical foramen in the distal root. (Source: personal documentation).
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case_images: The distal root possesses a single apical foramen, whereas the mesial root contains two apical foramina (Figure 6A-D).
case_images: Pre-operative CBCT radiolucency image at the apex of tooth 47. (A) The coronal view shows a radiolucency diameter at the apex of tooth 47 measuring 5.88 mm; (B) The axial view of the periapical lesion on the CBCT shows no evidence of bone expansion or destruction. (Source: personal documentation).
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case_images: The CBCT scan revealed a radiolucent area at the apex of the tooth, measuring 5.88 mm in diameter (Figure 7A). The radiolucency has a periapical score of 4 as determined by the CBCT-PAI score (Figure 7B).  
case_images: The endodontic treatment process for tooth 47 involves the following steps: (A) Isolation of the tooth using a rubber dam, removal of decay, and gaining access to the cavity; (B) Negotiating the canals using #6 #8 #10 K-files and determining the working length using an Electronic Apex Locator (EAL); (C) Preparing the root canal using the crown-down technique with specially designed files (Protaper Ultimate, Dentsply Sirona, USA) that have a regressive taper and are heat-treated with gold metallurgy, up to size #30; (D) Cleaning the canal using irrigation solutions of 3% NaOCl, 17% EDTA, and 2% CHX, which are activated using the passive ultrasonic irrigation technique; (E) Drying and examining the root canal morphology after chemomechanical preparation; (F) Placing calcium hydroxide medication inside the canal for a period of 3 weeks. Upon examination, the patient's symptoms were completely disappeared, and tests involving percussion and biting showed no abnormalities. The obturation procedure utilized the warm hydraulic condensation approach, employing bioceramic sealer (AH Plus Bioceramic Sealer, Dentsply Sirona, USA). (Source: personal documentation).
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case_images: Non-surgical root canal treatment was performed at tooth 47, which involved removing decay and accessing the cavity (Figure 8A), determining the length of the root canal with an electronic apex locator (Figure 8B), cleaning and shaping the root canal (Figure 8C-E), applying medication within the canal, and obturating the root canal (Figures 8F and 9).  
case_images: Periapical X-ray during the obturation phase of root canal treatment for tooth 47. (A) Master cone fit; (B) Immediate post-obturation; (C) Post-obturation at 1-month recall. (Source: personal documentation).
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case_images: Non-surgical root canal treatment was performed at tooth 47, which involved removing decay and accessing the cavity (Figure 8A), determining the length of the root canal with an electronic apex locator (Figure 8B), cleaning and shaping the root canal (Figure 8C-E), applying medication within the canal, and obturating the root canal (Figures 8F and 9).  
case_images: Axial CBCT slices to evaluate the hermetic integrity of the root canal filling in a C-shaped canal. (Source: personal documentation).
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case_images: During this evaluation, the root canal filling was examined utilizing CBCT imaging (Figure 10). 
case_images: Post and Core Buildup Protocol: (A) placement of a glass fiber post into the distobuccal canal (Dentoclic, Itena, France), application of polyethylene fiber tape to the floor and cavity walls using the wallpapering technique. (B) A core buildup with short fiber reinforced composite (Ever X Posterior, GC, Japan) was done, followed by the morphologically driven preparation technique in overlay, including a proximal and buccal box. (C) Digital scanning and designing of the overlay using zirconia material. (Source: personal documentation).
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case_images: This involved creating a box-shaped structure on the proximal and part of the buccal surface that had previously been impacted by caries (Figure 11A and B). An intraoral scanner was used to capture an impression, which was then digitally designed utilizing zirconia material for the restoration (Figure 11C). 
case_images: Preparation of the Restoration: (A) An intraoral try-in of the zirconia overlay was performed, followed by cleaning with a universal cleaning paste (Ivoclean, Ivoclar Vivadent, Liechtenstein); (B) The bonding surface was sandblasted using air-particle abrasion with 50 microm aluminum oxide and thoroughly rinsed with water spray and dried with oil-free air; (C) A thin coat of primer was applied to the pretreated surfaces with a micro brush for 60 seconds, then any remaining excess was dispersed with a strong stream of air (Monobond N, Ivoclar Vivadent, Liechtenstein); (D) The zirconia overlay was ready to be luted with self-adhesive resin cement (Multilink Speed, Ivoclar Vivadent, Liechtenstein). (Source: personal documentation).
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case_images: Afterward, the zirconia overlay was subjected to air-particle abrasion and priming methods (Figure 12A-D).  Subsequently, the process of cementation was performed utilizing a self-adhesive resin cement (Figures 12D and 13E).
case_images: Tooth surface preparation using a two-bottle multimode bonding system (Optibond exTRa Universal, Kerr, USA). (A) Primer and adhesive bottles, each with a separate micro brush; (B-D) Tooth 47 was etched with 37% phosphoric acid for 15 seconds, then thoroughly washed and air-dried (Gel Etchant, Kerr, USA). The primer (first bottle) was applied using a micro brush with a scrubbing motion for 20 seconds, followed by air thinning for 5 seconds. The adhesive (second bottle) was then applied with a light brushing motion for 15 seconds, air-thinned for 5 seconds with strong air to prevent adhesive pooling, and light-cured for 10 seconds; (E) The zirconia overlay was cemented using self-adhesive resin cement (Multilink Speed, Ivoclar Vivadent, Liechtenstein); (F) Excess cement was cleaned, and occlusion was checked, with no adjustments needed. (Source: personal documentation).
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case_images: The tooth surface preparation involved three steps: etching with 37% phosphoric acid, followed by applying a primer and adhesive utilizing a two-bottle multimode bonding system (Figure 13A-D). Subsequently, the process of cementation was performed utilizing a self-adhesive resin cement (Figures 12D and 13E). The excess cement was removed, and the occlusion was examined and modified as needed (Figure 13F). 
case_images: Post-restoration bitewing radiograph. (Source: personal documentation).
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case_images: An intraoral radiograph known as a bitewing was obtained to assess the efficacy of the treatment (Figure 14). 