AUTHOR=Tai Zhaowei , Li Huxiao , Li Shuang , Wang Jian TITLE=Case Report: Multidisciplinary management of a rare labial–palatal dual developmental groove with malocclusion: a 4-year follow-up JOURNAL=Frontiers in Oral Health VOLUME=Volume 6 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/oral-health/articles/10.3389/froh.2025.1705402 DOI=10.3389/froh.2025.1705402 ISSN=2673-4842 ABSTRACT=ObjectiveThis study aims to present a multidisciplinary, minimally invasive treatment approach for a rare labial–palatal dual developmental groove associated with anterior malocclusion, emphasizing long-term periodontal stability, functional rehabilitation, and esthetic outcomes.Case presentationA 29-year-old female patient presented with a deep labial groove and a shallow distopalatal groove on the maxillary central incisor, complicated by severe localized periodontal destruction and malocclusion. Cone-beam computed tomography (CBCT) revealed a communication between the labial groove and the periapical lesion, whereas the palatal groove was isolated. A comprehensive three-phase treatment protocol was implemented, including root canal therapy combined with apical surgery, guided tissue regeneration (GTR) using Bio-Oss and Bio-Gide, and anterior esthetic rehabilitation through digital smile design and full-ceramic restorations.ResultsAfter 4 years of follow-up, the probing depth improved from 10 to 1 mm, with radiographic and CBCT evaluations confirming complete bone regeneration and reattachment of periodontal tissues. Functional and esthetic outcomes remained stable, and no recurrence or inflammation was detected during maintenance visits.ConclusionThis case highlights the diagnostic value of CBCT imaging and the effectiveness of an evidence-based multidisciplinary approach in managing complex labial–palatal dual-groove anomalies. Early diagnosis, bio-ceramic sealing, regenerative periodontal therapy, and meticulous long-term maintenance are essential for achieving predictable and durable clinical success in developmental radicular groove-associated lesions.