A novel clinical endodontic approach: Radix entomolaris

Aim

The present case report discusses the treatment of an endodontically treated mandibular molar tooth with three roots and four canals. Two canals were present in the mesial side and one each was present in the disto-buccal and disto-lingual side.

Background

Mandibular molars may have an additional root which may be located buccally or lingually. When it is buccally located it is called as radix paramolaris and when lingually located it is termed as radix entomolaris (RE). Hence, the presence of such a pulpal system calls for challenges in providing endodontic treatment.

Case description

A female child of 13 years age, reported to the Department of Pedodontics & Preventive Dentistry with a chief complaint of lancinating pain in the lower back region of the right side of the mandible. The pain was present for last two months. On clinical examination, the mandibular first molar of right side was deeply carious with tenderness on percussion. Intra oral periapical radiograph showed carious lesion involving enamel, dentin and pulp along with an extra root between the distal and mesial roots. To confirm that additional root is present, two intra oral periapical radiographs with different horizontal angulations were taken. After taking radiographs, an additional root was confirmed to be present on the disto-lingual side of the mesial root. Final diagnosis of irreversible pulpitis was made. The treatment modality planned was root canal treatment.