Background <p>Radicular grooves are relatively common, yet a standardized classification system and treatment regimen remain elusive. Existing classifications primarily focus on the morphological aspects of dental structures, overlooking the crucial periodontal condition of affected teeth. This oversight hampers the development of effective diagnostic and treatment protocols. Therefore, the article aims to present a classification that integrates the periodontal status of affected teeth and propose corresponding therapeutic approaches.</p> Methods <p>The article discusses four classes of radicular grooves based on the location of the deformity and the periodontal status of teeth. Each class is accompanied by a recommended treatment program. For the most severe class, a periodontal-endodontic surgical approach is suggested as an alternative to intentional replantation.</p> Results <p>The article presents the treatment process and outcomes for at least one case report for each class, achieving positive results across all classes. Notably, cases with deep periodontal pockets showed significant postoperative improvement.</p> Conclusion <p>This paper proposes a novel radicular groove classification system incorporating periodontal status, with treatment protocols specific to each category. Clinical case reports validate the clinical applicability of this approach, demonstrating favorable outcomes across all classification groups.</p>