Abstract
This case presents a novel microsurgical approach for managing a severe palatogingival groove (PGG) while preserving pulp vitality. A 29‐year‐old male exhibited a 10‐mm palatal pocket, buccal sinus tract, and an extensive through‐and‐through cortical plate defect on the maxillary right lateral incisor. Despite the PGG extending 6 mm apically, pulp sensibility remained normal. A conservative microsurgery featuring “selective curettage” was performed to preserve the apical neurovascular bundle. The defect was sealed using a two‐segment restoration: iRoot BP Plus radicularly and composite resin coronally. At the 2‐year follow‐up, the patient was asymptomatic with normal probing depths (< 3 mm), complete sinus tract resolution, substantial alveolar bone healing, and maintained pulp vitality. Combining selective curettage with a two‐segment restoration offers a predictable, biologically driven strategy for simultaneous periodontal regeneration and vital pulp preservation.