Endodontic treatment of the permanent mandibular first molar with a radix entomolaris: A case report and literature review

Abstract

Introduction: The success of endodontic treatment is based on correct determination of the number of roots and root canals. Therefore, variants in root number and root canal number are a constant therapeutic challenge. The permanent mandibular first molar (PMFM) usually has a mesial root with two canals and a distal root with one or two canals, but may also have a supernumerary root located distolingually - a radix entomolaris (RE). Case report: Recent studies have shown that RE invariably contains a single root canal. Although RE occurs with a relatively low prevalence in Caucasian patients, it may be the cause of endodontic failure if not identified before or during the treatment. The knowledge about the location of the additional root canal orifice will result in a modified access cavity design. Moreover, morphological features of the RE in terms of root inclination and curvature must be taken into account during root canal preparation to avoid procedural errors, such as straightening and ledging of the root canal, perforation or instrument fracture. Conclusion: This paper presents the endodontic retreatment of a PMFM with RE in a Caucasian patient and highlights the importance of a thorough radiographic and clinical examination.

Keywords

• permanent mandibular first molar
• root canal therapy
• supernumerary root
• anatomical variants
• morphology