To report a constant observation for four years after minimally invasive therapy of pre-eruptive intracoronal lesion, and to summarize the treatment experience for the patients.

A pre-eruptive intracoronal lesion in an unerupted permanent molar of a 6-year-old child was found upon radiographic examination prior to regular treatment. The affected tooth was exposed under local anesthesia after 9 months periodic examination when it was located under the gingiva. Minimal removal of soft dentine was taken and the direct pulp capping was performed. Periodic review was conducted for 4 years after the operation and the filling material was replaced as required.

The pulp of the affected tooth was successfully preserved and the root of the tooth was well developed.

There is no relevant diagnosis and treatment standard for such cases as we reported. However, early diagnosis and timely treatment before the exposure to the oral cavity are very important for the long-term prognosis of such affected teeth.