This live molar surgery of tooth #19 was recorded under ZEISS EXTARO 300 in Dr Kim’s office in New York City. The surgical intervention involves a bone window technique to address mesial and distal root lesions of lower first molar. Piezotome is becoming a useful adjunct for microsurgical cases especially when the cortical plate is intact. Instead of drilling a conventional osteotomy site with Lindenman bur and sacrificing that bone, the healthy bone can be preserved and will serves as an autologous graft in such cases. An incidental CBCT finding for this patient was a small cervical resorption lesion on the canine. The repair of the lesion with geristore was also accomplished during the surgical procedure.