Tipped molars are often compromised by improper axial inclinations and inadequate pontic space. As a further complication, an infra–bony pocket may be present as a result of periodontal disease. Such a situation is observed clinically where there has been loss of  permanent first molar and the lower second molar migrates mesially and tips into the edentulous area while the opposing molar supraerupts. A tilted abutment tooth consequently converts a simple procedure into a complex restoration. To prevent further complications, the abutment teeth should be uprighted prior to placement of fixed restorations. Occasionally, an infrabony pocket may occur on the mesial aspect of the tilted second molar. If there is an infrabony pocket present as well, a multidisciplinary approach involving orthodontic and periodontal disciplines may be necessary. Teeth with minimal osseous support can be uprighted, resulting in improved axial inclinations, crown–root ratios from occlusal reduction, and favourable changes in the contour of the alveolar crest. This article presents a clinical case report and the clinical problems that may arise when a tilted posterior tooth is used as an abutment