Root canal treatment may present a considerable number of different challenges of widely differing severity. Problems occurring during root canal treatment frequently require modifications of treatment and the use of specific materials and instruments. Some of these problems can be prevented by thorough case selection and proper treatment planning. Others can be managed more easily and successfully if their possible occurrence is anticipated; and strategies, instruments and materials for immediate management are available. Thus, diagnosis-related and problem-oriented treatment planning (and preparation) is recommended. The following case report presents an example for problembased endodontic treatment planning and treatment. Keywords: management, prevention, problems, root canal treatment, systemic diseases