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This case pertains to a 40-year-old man presenting with severe pain in the right mandible. The patient reported that there had been several abscesses in the past, treated with antibiotics. A buccal sinus tract was present. The tooth was tender to percussion and did not respond to thermal and electric pulp tests. A radiographs showed a large mesial caries lesion proximal to the mesial pulp horns, and periradicular, as well as interradicular, radiolucencies. The case was treted according to the principles of the Biologic Endodontic School, which include irrigation with 1% sodium hypochlorite and intracanal medication with calcium hydroxide until signs of root canal infection are no longer present. The canals were obturated, after a period of two weeks of intracanal medication, with a premixed bioceramic material and single gutta-percha cones. At the 2-year follow up the tooth wascomfortable and the radiographs showed complete interradicular and periapical healing.