Patient presented with on/off symptoms of pain in the URQ. A diagnosis of chronic PAP was made. The tooth had already been heavily restored with a composite and the patient wanted to avoid a crown if possible, despite advice. We proceeded to make as small of an access as possible, as occlusally was one area untouched by previous dentistry. We obturated as normal, used thermal techniques and back filled with an amalgam core. The case took slightly longer due to the presence of calcification with the chamber, which we removed using USs.