The presence of carious lesions in children associated with developmental defects of enamel is frequently observed. Restoring these affected teeth can be a challenge for the clinician. Teeth with enamel defects may have poor or limited resin adhesion and some may require repeated restoration. Prefabricated zirconia permanent molar crowns were recently introduced as an option for restoring severely decayed and broken down young permanent molars. These new restorations offer an efficient, esthetic, and economic option to restore severely broken down carious permanent molars that may be associated with enamel defects in partially or fully erupted molars. A clinical case of a 13-year-old female patient is presented. She had a mandibular second permanent molar that demonstrated significant caries and loss of much of the clinical crown, which was treated with a vital pulpotomy and restored with a prefabricated zirconia crown.