Apical root lesions are usually treated with infected root canal therapy, although teeth with previous root canal therapy may be treated with surgical endodontic procedures such as root-end resection. However, such treatment may be difficult in cases where the affected tooth has a calcified root canal. The present case involved a female dentist in her 40s who was aware of forceful bruxism. The occlusion was canine-guided, and craze lines on the upper and lower canines suggested occlusal trauma. Preoperative dental X-rays showed that the pulp chamber had almost disappeared. The author suspected that forceful bruxism may have been connected to the craze lines and calcification and the disappearance of the pulp chamber. The author performed infected root canal treatment as usual, but were unable to penetrate the root canal. Dental cone beam computed tomography revealed a narrowed root canal near the root apex, and microendodontic surgery was performed. Two years after surgery, bone regeneration was observed at the root apex and the patient showed satisfactory progress.