Experience has led some clinicians to the conclusion that large areas of apical bone loss can’t be managed without surgical intervention. And in some instances, that may be the case. However, often, in large areas of apical bone less where the cause is endodontic in nature, nonsurgical endodontics can provide a predictable and favorable outcome. In this case, there was a history of trauma to the maxillary incisor. The apical finding is larger than a centimeter in diameter in both the buccolingual plane and inciso-apical plane (A,B). The tooth was accessed and medicated with Calcium Hydroxide for a few months. When initial signs of healing were observed radiographically, the tooth was obturated and restored. At two years, complete healing can be observed both in 2D and 3D (C,D). Large areas of bone loss can provide treatment planning challenges in the esthetic zone. In addition, many patients are taking medications that put them at risk for bone necrosis of the jaws when subjected to surgical interventions. Often endodontics can help in managing these situations.