Patients present with a variety of challenges to the endodontist. Calcific metamorphosis or “calcification” is particularly interesting because it occurs naturally and/or in response to trauma. This becomes a treatment barrier for many practitioners but if properly trained and managed, these can become successful cases and provide patients with relief of pain and swelling and return their teeth to normal function. Dr. Nguyen and Dr. Moran utilizes all the available tools at their disposal to manage these cases, including fiber optic transillumination, ultrasonic instrumentation and irrigation, surgical microscope visualization, and, if necessary, cone bean CT.