In addition to pathogenic teeth associated with cysts, the roots of adjacent teeth are often included in the cystic cavity. Whether these teeth require elective endodontic treatment followed by cystic enucleation remains unclear. In the case presented herein, we aimed to preserve the pulp of the teeth included in the cystic lesion. Unfortunately, the sensibility of the included teeth was negative after endodontic surgery, including cystic enucleation. However, the sensibility recovered after 1 year and was maintained throughout a 4.5-year follow-up. Therefore, we suggest that elective endodontic treatment of the included teeth should be avoided, and further research should be conducted regarding this issue. (EEJ-2022-05-063).