Endodontic Treatment of a Mandibular Molar with Radix Paramolaris: A Case Report

Ove Peters,Shreyas Oza,Gordon Lai,Samer Ebeid,Raymond Scott,Julian Shen

doi:10.31487/j.ord.2021.01.01

Abstract

Anatomical variations of the root canal system of mandibular molars are common and often present challenges for endodontic treatment. In some cases, an additional root is located in the distolingual, radix entomolaris (RE), or more rarely in the buccal, radix paramolaris (RP). This case report illustrates rare nonsurgical retreatment of the complex root canal morphology of a RP and demonstrates the utility of cone-beam computed tomography (CBCT) and 3D printing in managing such a case. Underscored is the need for clinicians to understand the possible variations of root canal morphology of mandibular molars and the role CBCT imaging can play in addition to periapical radiographs in order to successfully treat a tooth with radix paramolaris.

Highlights

Efficient and effective root canal treatment obviously requires an understanding of root canal anatomy
While there is a growing body of evidence on the prevalence of 3-rooted canal configuration in mandibular molars, only scarce information is available to describe the clinical management of radix paramolaris cases
This case report illustrates the utility of cone-beam computed tomography (CBCT) and 3D printing in the nonsurgical retreatment of a case with radix paramolaris (RP) and a failing root canal treatment

Summary

Introduction

Efficient and effective root canal treatment obviously requires an understanding of root canal anatomy. A more recent study based on cone-beam image acquisition in an Indian population found RP in first and second molars in 2/299 and 5/322 cases, respectively [8]. While there is a growing body of evidence on the prevalence of 3-rooted canal configuration in mandibular molars, only scarce information is available to describe the clinical management of radix paramolaris cases. This case report illustrates the utility of cone-beam computed tomography (CBCT) and 3D printing in the nonsurgical retreatment of a case with RP and a failing root canal treatment. The patient returned to Egypt and was unavailable for additional follow-up

Findings

Discussion

Conclusion