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Palatogingival groove is a rare developmental anomaly of a tooth, which is often located at the palatal side of the maxillary lateral incisor following maxillary central incisors. These palatogingival groove leads to endodontic and periodontal problems and eventually tooth loss if not diagnosed appropriately. It is a challenge for a clinician to diagnose it early; likewise treatment protocol is also unpredictable. Hereby, is a case of a 17-year-old female patient, based on history, clinical examination and radiographs timely identification of periodontitis due to a palatogingival groove was diagnosed in bilateral maxillary lateral incisors. Early diagnosis enabled conservative treatment, arrested disease progression, and showed regenerative outcomes after one year of follow-up.