Early caries involvement and gross destruction of permanent mandibular first molars results in reduced masticatory efficiency and later may be malocclusion, esthetic and psychological problems for a smaller extent. Since most of the coronal structure is lost or damaged, routine direct restorative procedures do not always give satisfactory results. The restoration of shape, function and esthetics of badly decayed or severely damaged teeth is often a difficult task or a challenge to Pediatric Dentist. Such teeth are to be restored either by means of multiple Endo and restorative procedures or by Prosthodontic techniques. Here we present such a case where the crown structure was preserved by band adaptation and core build up followed by stainless steel crown placement. The calcium hydroxide and iodoform paste (Metapex) was placed in the root canals of immature permanent tooth. The tooth involved was evaluated at regular intervals for the first 12 months. At the end of 12 months, the case showed continued root growth and apical closure (apexification) with no evidence of periapical pathology. Later Conventional endodontic treatment was then performed. This case report highlights the importance to promote the Management of Badly Decayed Young Permanent Molar by conservative approach in children and can give promising results instead of extraction.
 

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