ABSTRACT
Background: Variations in the anatomy of the root and root canal systems may make endodontic treatment more challenging. Endodontic failure is linked to infection that persists after a missing or untreated canal. The mandibular first molars exhibit the most significant number of anatomical differences, not only in terms of the number of canals but also the amount of roots and morphology. Case Report: This case report presents the endodontic treatment of mandibular first molars with a radix entomolaris, which are rare macrostructures. Radix entomolaris was an additional root on the distolingual side of mandibular first molars. In this case, the radix entomolaris was found clinically and radiographically with root canal configurations such as curves. Case Management: Preoperative radiography was used to diagnose radix entomolaris, and the access cavity was modified before the canals were located, cleaned, and shaped using nickel–titanium instruments Protaper Next (Switzerland, Dentsply Sirona). Obturation was done with gutta-percha master cones (Switzerland, Dentsply Sirona) and calcium hydroxide sealer (USA, Kerr). The tooth was restored using indirect restoration onlay ceramage. Conclusion: In addition to three roots, the presence of additional roots, either lingually (radix entomolaris) or buccally (radix paramolaris), is one of the complex morphological variations. Diagnosis, identification, and treatment of these variations need adequate knowledge of root and root canal anatomy and configurations which can contribute to a better outcome.
