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Creating esthetics with long lasting structural and functional integrity has always been the goal and challenge in dentistry. Although endodontic treatment preserves the integrity of periapical tissues, it has been implicated as one of the contributing factors in influencing esthetics negatively. So, it is important for dental professionals to have a thorough knowledge and understanding of the etiology and select the most appropriate treatment for each case to establish structural integrity and manage esthetics in root canal treated teeth.