Palatogingival groove is an anatomical malformation that often causes severe periodontal defects. Treatments of such an anomaly present a clinical challenge to the operator. Careful endodontic and periodontal procedures may restore the form and function. In the present case; root canal therapy, apicectomy, and sealing of the groove with Biodentine™ were done. Bone graft was placed followed by platelet-rich fibrin (PRF) membrane. This treatment modality resulted in gain in attachment, reduction in pocket depth, and deposition of bone in the osseous defect. A 24 month follow-up is included.