Journal of Dental Science, Oral and Maxillofacial Research
Treating mandibular molars with extra roots -Radix
entomolaris
Philip Pradeep,
1
Gurudutt Nayak,
2
Neha Arya
3
1
Department of Conservative Dentistry and Endodontics, Penang International Dental College, Malaysia
2
Department of Conservative Dentistry and Endodontics, Mansarovar Dental College & Hospital,
India
3
Department of Conservative Dentistry and Endodontics, Seema Dental College & Hospital, India
Correspondence: Philip Pradeep, Lecturer, Department of Conservative Dentistry & Endodontics, Penang International Dental
College, Penang, Malaysia, 12000, Tel +60 16 5153342, Email philippradeep@pidc.edu.my
Received: May 30, 2018 | Published: June 05, 2018
Copyright© 2018 Pradeep et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original author and source are credited.
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Citation: Pradeep P, Nayak G, Arya N. Treating mandibular molars with extra roots -Radix entomolaris. J Dent
Maxillofacial Res. (2018);1(1):13–16. DOI: 10.30881/jdsomr.00005
Introduction
Cleaning and shaping of the root canals plays a vital role in
eliminating endodontic pathology. In order for endodontic therapy to
be successful, it is better for the clinician to be aware of the presence
of unusual root canal morphology.
1
Anatomical variations of the
mandibular molars have been reported time and again. Generally, the
mesial root possesses two root canals, ending in two distinct apical
foramina. In some cases, they merge together at the root tip to exit in a
single foramen. On the other hand, the distal root typically portrays a
single kidney-shaped root canal, although if the orifce is particularly
narrow and round, a second distal canal may be present.
2
Numerous
anatomical variations of the mandibular frst molar have been reported
by Fabra-Campos,
3,4
Bond
5
(three mesial canals), and Stroner
6
(three
distal canals).
It is not just the root canals which show anatomic variations; in some
cases the tooth may be found to have an extra root. An additional
root located distolingually is called radix entomolaris (RE), and
when located mesiobuccally is called radix paramolaris (RP).The
Latin term RE was coined by Mihaly Lenhossek in 1922 to describe
the supernumerary root on the lingual aspect of mandibular molars.
Bolk in 1915 named it radix praemolarica, as he presumed only the
mandibular frst molars displayed such a variant. In the later years,
this additional root was also found to occur on the mandibular second
and third molars, and even on the frst and second primary mandibular
molars.
Some authors prefer to use the following terms, either separately
or interchangeably with RE: distolingual root, distolingual extra
root, additional distal root and extra distal root. When it comes to
the second and third permanent mandibular molars, the RE may be
located mesiolingually, or exactly midway between both main roots.
Hence, the usage of the broad term RE over positional terms is that
it covers all variants of this root and therefore applies to all types of
mandibular molars.
7
This typical morphological variant does seem to show a strong racial
predilection. According to Tratman (1938), the frequency of occurrence
is found to be less than 5% in Eurasian and Indian subgroups. The
frequency is much higher in populations demonstrating Mongoloid
traits, ranging from 5 to over 30%.
1
In Caucasians, however, this
percentage drops down to 3.2-4.2%. Table 1 shows studies carried out
by various researchers to demonstrate the prevalence of extra canals
in mandibular frst molars.
8
An RE can be found on the frst, second
and third mandibular molar, occurring least frequently on the second
molar.
9
Some studies report a bilateral occurrence of the RE from 50
to 67%.
10,11
The present article describes the endodontic management of
mandibular frst and second molar with RE. The identifcation of this
variation was done with the help of multi-angled radiographs.
Case Report
Abstract
On occasion, the clinician will come across a mandibular molar with an extra root located either lingually (the radix entomolaris) or buccally (the radix
paramolaris). On encountering such cases in the clinic, it is always better for the dentist to have a sound knowledge of the variant root canal morphology
beforehand. This report deals with the management of radix entomolaris cases, which might leave the inexperienced clinician in a dilemma with respect to
diagnosis and subsequent treatment.
Keywords: radix entomolaris, radix paramolaris, distolingual root