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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
Fisher DE, Ingersoll N, Bucher JF. Anatomy of the pulpal canal: three-dimensional visualization. J Endod. 1975; 1:22-25 https://doi.org/10.1016/S0099-2399(75)80245-7
Krasner P, Rankow HJ. Anatomy of the pulp-chamber floor. J Endod. 2004; 30:5-16 https://doi.org/10.1097/00004770-200401000-00002
Shemesh A, Levin A, Katzenell V Prevalence of 3- and 4-rooted first and second mandibular molars in the Israeli population. J Endod. 2015; 41:338-342 https://doi.org/10.1016/j.joen.2014.11.006
De Moor RJ, Deroose CA, Calberson FL. The radix entomolaris in mandibular first molars: an endodontic challenge. Int Endod J. 2004; 37:789-799 https://doi.org/10.1111/j.1365-2591.2004.00870.x
Nair MK, Nair UP. Digital and advanced imaging in endodontics: a review. J Endod. 2007; 33:1-6 https://doi.org/10.1016/j.joen.2006.08.013
Curzon ME. Miscegenation and the prevalence of three-rooted mandibular first molars in the Baffin Eskimo. Community Dent Oral Epidemiol. 1974; 2:130-131 https://doi.org/10.1111/j.1600-0528.1974.tb01670.x
de Souza-Freitas JA, Lopes ES, Casati-Alvares L. Anatomic variations of lower first permanent molar roots in two ethnic groups. Oral Surg Oral Med Oral Pathol. 1971; 31:274-278 https://doi.org/10.1016/0030-4220(71)90083-1
Ferraz JA, Pécora JD. Three-rooted mandibular molars in patients of Mongolian, Caucasian and Negro origin. Braz Dent J. 1993; 3:113-117
Curzon ME. Three-rooted mandibular permanent molars in English Caucasians. J Dent Res. 1973; 52 https://doi.org/10.1177/00220345730520011901
Calberson FL, De Moor RJ, Deroose CA. The radix entomolaris and paramolaris: clinical approach in endodontics. J Endod. 2007; 33:58-63 https://doi.org/10.1016/j.joen.2006.05.007
Bhavana V, Rani A, Swetha K, Nimeshika R. Endodontic management of mandibular first molar with 4 roots and 6 canals – a case report. J Dent Health Oral Disord Ther. 2018; 9:146-148
Penumaka SL. Endodontic treatment of permanent mandibular first molar with 4 roots and 5 canals-clinical case reports. Dentistry. 2018; 8
Carlsen O, Alexandersen V. Radix entomolaris: identification and morphology. Scand J Dent Res. 1990; 98:363-373 https://doi.org/10.1111/j.1600-0722.1990.tb00986.x
De Moor RJ, Deroose CA, Calberson FL. The radix entomolaris in mandibular first molars: an endodontic challenge. Int Endod J. 2004; 37:789-799 https://doi.org/10.1111/j.1365-2591.2004.00870.x
Hargreaves KM, Cohen S, Berman LH. Cohen's Pathways of the Pulp, 10th edn. St Louis, Mo: Moby Elsevier; 2011
Mandke L. Importance of coronal seal: preventing coronal leakage in endodontics. J Res Dent. 2016; 4:71-75
Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 2: tooth survival. Int Endod J. 2011; 44:610-625 https://doi.org/10.1111/j.1365-2591.2011.01873.x

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

Email 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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