This case report describes the endodontic, periodontal, and restorative treatment of a maxillary incisor with unusual external and internal anatomy. The right central and lateral incisors had fused, resulting in an oversized unaesthetic central incisor. A small diastema was present between the fused central incisor and the canine. Since overpreparation of the tooth during restoration was anticipated, endodontic therapy was accomplished. Periodontal flap surgery provided an opportunity to reduce the root diameter and narrow the emergence profile of the tooth and to eliminate a plaque-retentive palatogingival groove. A cast post and core rigidly obturated the canal space and provided a preparation on which to fabricate a metal-ceramic restoration simulating the replacement of the right lateral incisor. The final restoration provided significant aesthetic improvement. The learning objective of this article is to familiarize the reader with multidisciplinary restorations.