Bacterial plaque has been implicated as the primary etiologi factor in the initiation and progression of periodontal disease. Anatomic factors, such as cervical enamel projections, enamel pearls, and radicular grooves, are often associated with advanced localized periodontal destruction. Enamel projections and pearls are most often ass ociated with molars, while radicular grooves are usually located on the palatal aspect of maxillary incisors. Gingival fenestrations are of uncertain etiology and have rarely been reported in the dental literature. An unusual case is presented of a cervical enamel projection located on the facial aspect of a maxillary central incisor in association with gingival fenestration. Rationale for therapy and likely healing results are discussed