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Endodontic microsurgery (MS)with bone graft and membrane placement (guided tissue regeneration (GTR)) is the proposed treatment for such cases. This article is aimed at discussing an unusual treatment protocol for a large through\u2010and\u2010through lesion without the use of bone grafting or membrane. A 26\u2010year\u2010old Air Force pilot traveling at high altitudes presented to the Endodontic division for management of pain and swelling related to the upper left anterior lesion concerning Teeth #21, #22, and #23. Following a thorough clinical examination, medical history, and clinical and radiographic examination, the diagnosis of the presence of a through\u2010and\u2010through lesion related to previously treated teeth. The treatment plan included endodontic MS without the use of GTR due to his work nature. Over 3 years, routine follow\u2010ups were essential for tracking the damaged area\u2019s healing process, which ultimately resulted in full recovery. This case emphasizes how crucial it is to obtain a thorough history and use a multidisciplinary approach to diagnose and manage through\u2010and\u2010through lesions, achieving positive outcomes.<\/jats:p>","DOI":"10.1155\/crid\/7225338","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T01:17:59Z","timestamp":1745371079000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Healing of Extensive Through\u2010and\u2010Through Periradicular Lesion Using Apicoectomy Without Bone Grafting: A Case Report With 3\u2010Year 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