Endodontic management of a mandibular second molar with radix entomolaris: a case report

Abstract

The presence of radix entomolaris (RE) in a mandibular first molar is a common occurrence in certain ethnic groups, but the presence of RE in a mandibular second molar is a rare occurrence. In the present case, RE was identified from preoperative radiographs and confirmed using cone-beam computed tomography (CBCT). The access cavity was modified to locate the RE. Cleaning and shaping were performed with nickel-titanium rotary instruments. Obturation was completed with gutta-percha cones using AH Plus (Dentsply Detrey GmbH) as sealer. From the CBCT axial images, the RE was determined to have a Type III curvature by the De Moor classification, Type B separate RE by the Carlsen and Alexandersen classification, and radiographically, a Type i image by the Wang classification. The presence of RE in the mandibular second molar makes it essential to anticipate and treat the distolingual root canal. This case report highlights the usefulness of CBCT for assessing RE in the mandibular second molar, which can help the clinician in making a confirmatory diagnosis and assessing the morphology of the root canal.

Unusual root morphology in second mandibular molar with a radix entomolaris, and comparison between cone-beam computed tomography and digital periapical radiography: a case report

“…Alterations in number of roots have been observed in an “ in vivo ” study [ 20 ] with patients from China, revealing that 1.3% of mandibular second molars had three roots. Two cases with patients of Indian origin [ 30 , 31 ] reported similar features (three roots, RE). Furthermore, a case (extracted mandibular second molar) with four roots in a patient from Sri Lanka [ 32 ] was reported.…”

Endodontic Treatment of a Mandibular Second Molar Featuring Vertucci Type V Configuration in the Distal Root: A Case Report

“…Additionally, the prevalence of post-treatment apical periodontitis is often linked to missed canals due to incomplete eradication of the bacterial biofilm within the root canal system, which may lead to the onset or persistence of apical periodontitis [4,14]. A deep understanding of the anatomical variations of mandibular second molars is crucial for clinicians to effectively identify all roots and canals [15][16][17].…”

Endodontic management of radix entomolaris in second molar

“…The most common variations among the mandibular first molars are three roots which were first documented by Carabelli known as radix entomolaris (RE), i.e., the presence of distolingual supernumerary root or mesiobuccal root which is known as radix paramolaris. [ 3 4 ] This has a frequency of 5%–30% among the mongoloids such as Chinese, Eskimos, and Native Americans populations and a frequency of <5% in white Caucasians, Africans, Eurasians, and Indian populations. [ 5 ]…”