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References

de Pablo OV, Estevez R, Péix Sánchez M Root anatomy and canal configuration of the permanent mandibular first molar: a systematic review. J Endod. 2010; 36:1919-1931 https://doi.org/10.1016/j.joen.2010.08.055
Iqbal A. The factors responsible for endodontic treatment failure in the permanent dentitions of the patients reported to the College of Dentistry, the University of Aljouf, Kingdom of Saudi Arabia. J Clin Diagn Res. 2016; 10:ZC146-148 https://doi.org/10.7860/JCDR/2016/14272.7884
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A rare finding of a radix entomolaris and radix paramolaris in a lower first mandibular molar requiring endodontic treatment: a case report

From Volume 49, Issue 6, June 2022 | Pages 515-518

Authors

Lorna Gladwin

BDS, MFDS

DCT2 Restorative Dentistry, Manchester Dental Hospital

Articles by Lorna Gladwin

Email Lorna Gladwin

Jaymit Patel

BSc, BDS, MFDS, PGCert

StR Restorative Dentistry

Articles by Jaymit Patel

Abstract

The success of endodontic treatment lies in the ability to appropriately access, clean and debride the entire root canal system to prevent or treat peri-apical pathology. The ‘conventional’ anatomy of a lower first molar consists of one mesial root usually with two canals and one distal root containing a single canal. Variations of this anatomy may present many clinical challenges to the operator. This case report is a summary of the clinical considerations for endodontic treatment of a symptomatic lower first mandibular molar with four roots and five canals.

CPD/Clinical Relevance: Dental professionals should be aware of variations in root canal anatomy.

Article

One of the most cited reasons for failure of conventional root canal treatment is missed anatomy.1,2 There are many different anatomic variations of pulpal anatomy.3 Awareness of these variations is essential to optimize access and chemo-mechanical debridement, and thus success. While using the well-described principles of pulp chamber anatomy is of significant importance,4 a detailed pre-operative assessment can sometimes give an indication of additional anatomic considerations. These include additional cusps, altered crown morphology, variations in the radiographic appearance of roots, root canals, apical anatomy or the periodontal ligament. There are two rare variants involving the presence of additional roots associated with lower first molars: radix entomolaris (RE, the presence of an additional distolingual root); and the rarer radix paramolaris (RP, the presence of an additional mesiobuccal root).5 The purpose of this case report is to discuss the endodontic management of a mandibular first molar with four roots and five canals.

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