Maxillary lateral incisors often exhibit embryological variations and developmental anomalies. The palato-gingival groove (PGG) is a rare anomaly that can pose difficulties in accurate diagnosis and treatment planning. Its presence can predispose to localized periodontal involvement, pulpal necrosis and combined periodontal-endodontic lesions. This case report describes the combined endodontic and surgical management of a complex type of palato-gingival groove in a maxillary right lateral incisor with two canals which was diagnosed with the help of cone beam computed tomography (CBCT) and successfully managed using advanced bioactive materials. CPD/Clinical Relevance: Clinicians should be familiar with the diagnosis and treatment planning in cases with a palato-gingival groove. Complex cases require combined endodontic and periodontal therapy. Autologous platelet rich fibrin (PRF) is a simple and cost-effective healing aid which helps in the regeneration of attachment apparatus.
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