Concrescence of a tooth is a condition showing union of adjacent teeth by cementum. The major variant in this case report is a concrescence between a supernumerary tooth (paramolar) with a permanent tooth. As a result of this paramolar concrescence, the gingival architecture was lost which created funnels for the accumulation of plaque and resulted in severe periodontitis. This case was successfully treated by sectioning the paramolar. Awareness of these developmental disturbances with proper diagnosis and treatment is very essential because it can compromise the periodontal attachment and can lead to tooth loss.
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