Pulpitis develops at #4 due to DO caries 1 year 5 months post cementation (Fig.6 *).  The crown at #3 is removed for easy and conservative DO carious removal and Cavit temporary restoration to prevent sodium hypochlorite leakage.  Then occlusal access is made for pulpotomy.  The patient returns for RCT 1 month later (Fig.7,8). Cavit remains in place (Fig.7 C).  Although 2 threads are exposed distal (Fig.8 arrow), there is no sign or symptom of periimplantitis, which may be related to the thick gingiva (arrowhead).  Bone Expansion Alterative with Drilling Last Next Xin Wei, DDS, PhD, MS 1st edition 09/04/2017, last revision 09/08/2019