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This study compared the six to nine month follow-up results of endodontic treatment completed on necrotic cases in either two appointments using calcium hydroxide as an intercanal medicament or one appointment using no intercanal medicaments. The root canals of 43 necrotic single-rooted teeth with the presence of periapical bone loss were thoroughly instrumented and irrigated with sodium hypochloride solution. Twenty-three teeth were treated with calcium hydroxide for 10-21 days, then obturated. Twenty teeth were treated in one appointment. Then each case was seen one year later for a recall appointment. The post-op x-ray was compared to the recall x-ray. A case was considered a success if either no apical lesion was present or the lesion had reduced in size and no symptoms were present. A case was considered a failure if the size of the apical lesion had remained the same or increased or if symptoms were present. All 23 of the necrotic teeth treated with calcium hydroxide were successful. Twelve of the 20 necrotic teeth treated in one appointment were successful. This study shows a connection with using calcium hydroxide in necrotic cases and a more reliably achievement for success.