diverse morphological tooth anomalies are found in various shapes , textures , and prevalence . they can be sporadic or syndromes , nutritional , environmental , genetic , and ethnic related . most of these tooth - born deformations ( e.g. , shovel - shaped incisors , tuberculum carabelli , variations in number and shape of cusps , dens invaginatus , taurodontism , palatogingival groove ) have been extensively investigated . labial - cervical - vertical groove ( lcvg ) , which starts on the cervical enamel and extends to the radicular surface , has also been described as a notch . it is assumed that this malformation is a developmental anomaly in which an infolding of the enamel organ and hertwig 's epithelial root sheath create a groove on the labial surface of permanent maxillary incisors . causative factors for this malfunction may be due to trauma , disease , and nutritional issues , or can be genetic or idiopathic . lcvg runs vertically from the crown surface to the root , starting at the enamel on the crown and extends apically , crossing the cementoenamel junction and resembling a short furrow . this furrow gradually grows deeper in the apical direction and may , occasionally , run throughout the root surface . anatomic factors , such as cervical enamel projections , enamel pearls , and radicular grooves are associated with advanced localized periodontal destruction . the presence of lcvg may exacerbate some clinical aberrations , such as esthetic deficiency of the gingival marginal contour , accumulation of plaque and , consequently , gingival pocket with bone loss as well as failure in endodontic and periodontal treatments . describe a 25-year - old female in which a periodontal lesion with vertical bone loss was directly related to the labial groove on a maxillary central incisor . this type of dental deformity has been scarcely investigated and reported in the dental literature . to the best of our knowledge and based on the available data , there are no reported cases of intrabony defect associated with lcvg treated with platelet rich fibrin ( prf ) . this article reports the effectiveness of prf for the treatment of intrabony defect associated with lcvg in the area of maxillary left central incisor . a 47-year - old male patient reported to the department of periodontology , with a chief complaint of pus discharge from maxillary left central incisors with dull intermittent pain . the patient was a non - smoker . on clinical examination , a localized gingival inflammation was present with soft edematous tissue with the accumulation of plaque and calculus with # 11 and # 21 . periodontal examination depicts a pocket depth of 11 mm on mesial aspect and 8 mm on midbuccal aspect of # 21 [ figure 1 ] with no mobility . fremitus was found to be negative precluding the possibility of trauma from occlusion and tooth was found to be vital electric and thermal pulp testing . on radiographic examination , a tear - shaped radiolucency was present with localized bone loss in # 21 [ figure 2a ] . on careful examination , clinical symptoms subsided , but the deep pocket was still present and hence a periodontal surgery was carried out to eradicate the underlying problem . the procedure was explained to the patient and the consent was obtained for the same . routine blood investigations were done . after assuring surgical asepsis , a pre - procedural rinse with 0.2% after administration of local anesthetic ( 2% lignocaine with 1:80000 adrenalin ) , the papilla preservation flap ( takei et al . ) was adopted since there was sufficient space between the maxillary central incisors . the exposed root surfaces were thoroughly scaled and root planed and bone defect carefully curetted . lcvg noted on # 21 [ figure 3a ] , terminated in the cervical third of root surface was sealed with glass ionomer cement ( fuji ii ; gc corporation , tokyo , japan ) [ figure 3b ] . pre operative pocket depth of 11 mm on mesial aspect and 8 mm on midbuccal aspect of # 21 ( a ) pre operative radiolucency with # 21 ; ( b ) post operative radiograph with # 21 at 6 months ( a ) lcvg noted on # 21 ; ( b ) lcvg was sealed with glass ionomer cement the prf was prepared following the protocol developed by choukroun et al . briefly , the procedure of prf preparation : 10 ml intravenous blood was collected by venepuncture at the antecubital fossa . this was transferred into 10 ml sterile tube without anticoagulant and immediately centrifuged at 3000 rpm for 10 min . fibrin clot formed in between the acellular plasma on top and the red blood cells at the bottom were separated using sterile tweezers and scissors [ figure 4 ] . amoxicillin 500 mg thrice for 7 days and analgesic  aceclofenac 100 mg twice for 3 days . prf was placed in the intrabony defect with # 21 then , 1 week postoperatively , the dressing was removed and saline irrigation was done . the patient was monitored at regular intervals and was under maintenance therapy . at the end of 3 months and 6 months the clinical measurements were repeated and compared to the baseline values . on examination during subsequent follow - ups , treated area showed satisfactory healing without any post - operative complications . the pocket depth was 2 mm on mesial and 1 mm on midbuccal aspect at 6 months [ figure 6 ] . periodontal health was stable and bone regeneration was noticed in radiograph [ figure 2b ] . post operative pocket depth of 2 mm on mesial and 1 mm on midbuccal aspect of # 21 at 6 months periodontitis is a multifactorial infectious disease affecting primarily a subset of subjects and subset of sites . recent microbiological data have acknowledged that before disease progression can occur , a susceptible host and site are required , in addition to the presence of pathogenic bacteria . retrospective studies clearly suggest a strong association between anatomic aberrations ( lcvg ) and periodontal attachment loss . anatomic aberrations like root grooves can occur here , which form stagnant sites or ecological niches favoring the retention and growth of micro - organisms . grooves may facilitate plaque growth by providing surface areas sheltered from cleaning efforts as well as host defense mechanisms . later , bacterial selection and growth may be influenced by anaerobic conditions established inside the grooves . these grooves can be classified into mild , moderate , and complex based on its depth and extent . it has been pointed out that defect may vary from a simple , shallow developmental groove , to a complete lack of closure of calcified tissues , allowing for a direct soft tissue connection between the pulp and the periodontium . the presence of lcvg may exacerbate some clinical aberrations , such as esthetic deficiency of the gingival marginal contour , accumulation of plaque and , consequently , gingival pocket with bone loss , as well as failure in endodontic and periodontal treatments . describe a 25-year - old female in which a periodontal lesion with vertical bone loss was directly related to the labial groove on a maxillary central incisor . we have also observed an intrabony defect directly related to lcvg on # 21 . in the presence of periodontal disease , the therapeutical options for lcvg consist of grinding and flattening the affected area of the tooth or placement of a physical barrier between the tooth and soft tissue flap . the intra osseous defect , if present can be grafted with various bone graft materials . it is considered as a second - generation platelet concentrate and has been used in various surgical procedures in an attempt to enhance wound healing . it is prepared from the patient 's own blood thereby eliminating the possibility of disease transmission or foreign body reactions . blood is drawn into standard glass / silica coated blood collection tubes and centrifuged at a predetermined speed to ensure cell separation . this unique preparation technique allows prf to trap at least 95% of the platelets of the collected blood into a fibrin mesh . the fibrin mesh can then be easily manipulated into a membrane that allows it to be transferred to any surgical site . here , high concentrations of the collected platelets allow for the slow release of growth factors ( gfs ) from the platelet granules . these gfs include vascular endothelium growth factor ( vegf ) , platelet - derived growth factor ( pdgf ) , fibroblast growth factor ( fgf ) , epidermal growth factor ( egf ) , hepatocyte growth factor ( hgf ) , insulin - like growth factor ( igf ) , and transforming growth factor- ( tgf- ) . all of these play a role in replacing lost tissue , resurfacing of the wound , and restoring vascular integrity . compared to other platelet concentrates , prf releases these factors at a sustained rate over a longer period , thereby optimizing wound healing . recently , prf has also been shown to stimulate the growth of osteoblasts and periodontal ligament cells , both of which are significant for the regeneration of periodontal defects . currently , prf has been successfully tested in a number of procedures including maxillofacial surgery , periodontal surgery , and implantology . mazor et al . successfully used prf as the only grafting material in a series of sinus augmentation procedures . in a similar 6-year follow - up study , simonpeiri et al . were able to demonstrate that using prf as a sole grafting agent was a viable long - term option in sinus augmentation procedures . prf has also been used successfully to treat periodontal defects . in a series of clinical trials conducted by pradeep and sharma it was shown that prf could be used as a guided tissue regeneration ( gtr ) membrane to affect periodontal regeneration in three wall bony defects and degree ii furcation lesions . published several case reports showing the successful use of prf membranes in the management of both single and multiple gingival recession defects . and shah confirmed this observation and showed that prf could be used for root coverage procedures . in the presented case , lcvg was sealed with glass ionomer cement ( fuji ii ; gc corporation , tokyo , japan ) and associated intrabony defect was treated with prf . the lcvg is a potential problem area , which should be evaluated and treated accordingly . the groove can lead to combined endodontic periodontic lesions , which are difficult to deal with ; attention has been brought to its presence and clinical significance .