Extra Root Research Articles

Correlation between presence of radix entomolaris in mandibular first molars and C-shaped canals in mandibular second molars: a sample of CBCT scans in Taiwanese students

The anatomy of root canals is so complex that in many cases it is not sufficient to take an intraoral radiograph to diagnose the number and shape of root canals. Therefore, Cone Beam Computed Tomography (CBCT) facilitating diagnosis and treatment planning in endodontics is gaining more and more importance. Radix entomolaris is an extra root which is found in mandibular molars and located distolingually. C-shaped canal is most commonly found in mandibular second molars and can differ significantly in shape from the typical anatomy of lower molars. The aim of the study was to evaluate the correlation between presence of radix entomolaris in mandibular first molars and presence of C-shaped mandibular second molars in Taiwanese students based on CBCT scans. The material consisted of 19 CBCT examinations taken in the Department of Dental and Maxillofacial Radiodiagnostics of the … Among 19 CBCT examinations 5 cases of coexistence of additional root and C- shaped canals were found. Up to 80.0% of cases were bilateral. In the studied sample there was high coincidence of radix entomolaris in mandibular first molars and C-shaped mandibular second molars. Knowledge of this correlation will prevent diagnostic errors during endodontic and surgical treatment planning.

MANDIBULAR 2ND PREMOLAR WITH TWO ROOTS AND THREE CANALS: A CASE REPORT

Mandibular premolars have earned the reputation for having an aberrant anatomy. Literature is replete with reports of extra canals in mandibular second premolars, but reports about the incidence of extra roots in these teeth are quite rare. Before initiating any endodontic therapy, probability of extra canals should be considered. The Incidence of three canals in mandibular second premolar has been reported to be 0.46-0.5%. The present report describes nonsurgical endodontic treatment of mandibular second premolars with three canals. This case report explains non-surgical endodontic treatment of a mandibular second premolar with two separate roots and two separate buccal, and lingual canal orices and three canals namely Mesio-buccal, Disto-buccal and Lingual. Close attention to anatomic variations, thorough advance radiographic method like CBCT, thorough evaluation of the pulp chamber oor, and use of magnifying and optical devices have been recommended for the success of endodontic treatment of mandibular second premolars with complicated root canal system anatomy.

Endodontic Management of Mandibular First Molar with Four Roots - A Rare Case Report with Clinical Management Guidelines

Mandibular molar is usually two rooted with one mesial and one distal root. Additional roots are rare which requires accurate diagnosis and a methodical and scrupulous endodontic treatment. Objective: This paper aims to report the endodontic management of an unusual case of a mandibular permanent first molar with four roots (two mesial & two distal) and provide a clinical guideline to detect and manage these variant cases. Case report: A 15-year-old boy reported with a deep carious lesion in the lower left first molar (#36). The apical root contour of #36 on an intraoral periapical radiograph taken in different angulations suggested the presence of extra roots. A Spiral Computed Tomographic scan with multiplanar three-dimensional reconstructed images confirmed a fourrooted mandibular molar. Endodontic treatment of #36 was planned based on a diagnosis of pulpal necrosis with symptomatic apical periodontitis. The pulp chamber floor was assiduously explored along the developmental root fusion line (DRFL) to guide a trapezoidal access cavity and expose two mesial and two distal orifices. Conclusion: The present case report highlights the successful endodontic treatment of an atypical four rooted mandibular first molar by following a systematic approach from diagnosis to its clinical management.

Assessing supernumerary root occurrence as a possible adaptation enhancing teeth performance in Mediterranean deer populations

Teeth root morphology and integrity are essential to provide appropriate attachment, allowing for continuous and functional movement, with implications for adequate food processing, animal performance, and longevity. We studied the occurrence of supernumerary roots in mandibular molariform teeth of red deer ( Cervus elaphus Linnaeus, 1758) from seven separate populations spanning a range of latitudes in the Iberian Peninsula. We analyzed the influence of several factors, including sex, origin (native vs. reintroduced), lineage, and habitat, to assess extra root prevalence variations. The highest prevalence in deciduous teeth was found in pm3 (14%) and in permanent teeth in M1 (3%). We found significant differences between areas, lineages, and soil type; however, no significant relationships were found with the origin or the sex of individuals. We speculate that the high prevalence of supernumerary roots in M1 might be related to increased wear in grazers. Furthermore, we suggest that this high prevalence in deciduous teeth might be associated with a hard diet, dry climatic conditions, and a harsh weaning period, which indicate that supernumerary roots might have an adaptive value.

Effectiveness of modern agrotechnological approaches to the cultivation of chickpea in the conditions of North-Western Precaspian area

Chickpea has better drought resistant and productive properties than pea. Presently, chickpea is the main pulse crop cultivated in the Lower Volga Region because of its higher nutrient and feeding value. The study was aimed to identify the most effective variant of growth stimulation that would meet the requirements of resource sparing technology of chickpea cultivation in the Astrakhan region. Field trials and observations were performed according to the generally accepted methods proposed by Dospekhov and Moiseichenko. Field trials were conducted for the study of the influence of extra root treatment with growth stimulators at different phases of chickpea development and the pre-seeding inoculation with nitrogen-fixing microorganism strains. For the first time, for soil and climatic conditions of the North-Western Caspian Sea, features of chickpea crop formation were revealed depending on cultivation options in irrigation conditions. A comparative analysis was carried out with the identification of the most promising options. Methods and techniques of chickpeas cultivation in irrigation conditions ensuring production of highly productive commercial products are justified. Pre-seeding inoculation with microbiological agents and extra root (foliar) treatment with growth stimulators positively influenced the formation of the yield of the studied crop and the elements of the yield structure as well. Especially, this was evident in the variants with pre-seeding inoculation with microbiological agents that contained strains 065, 527 and in the variants with foliar dressing with Plantafol 10:54:10 and biostimulator Megafol, which significantly differed from the control variant.

Correlations between additional roots in maxillary second molars, maxillary first premolars, mandibular first molars and mandibular first premolars: a retrospective cone-beam computed tomography analysis.

This study aimed to determine the prevalence of additional roots in maxillary second molar (MSM), maxillary first premolar (MxFP), mandibular first molar (MnFM) and mandibular first premolar (MnFP) teeth and evaluate the correlations between the number of roots for these teeth. Images of 630 Turkish patients, in which all dental groups examined in the study were present bilaterally, were analyzed using cone-beam computed tomography. The images for the presence of the fourth root in MSMs, third root in MxFPs, distolingual root in MnFMs and complicated-root structure in MnFPs were assessed and divided additional roots into subgroups. The Chi-square test was used for categorical variables such as sex and tooth position. Logistic regression analysis was performed to understand the predictor variability of other teeth in teeth with extra roots. A p < 0.05 was considered statistically significant. Prevalence of the fourth root in MSMs was 1.75%, third root in MxFPs was 6.35%, third root in MnFMs was 3.57%, and complicated root in MnFPs was 21.9%. Positive correlations were observed between MSM, MxFP and MnFP teeth for increasing root numbers (P < 0.05). There was no significant correlation between root numbers of MnFM teeth and other tooth groups (P > 0.05) In the tooth groups examined, there was at least one explanatory variable (except for the right MnFM) tooth in addition to the contralateral tooth for the presence of additional roots.

CBCT-Based Evaluation of Root Canal Configurations of Mandibular Second Molars and Their Relation to Mandibular Canal in Central Gujarat Population-A Cross-Sectional Study

Aim: To evaluate root canal configurations of mandibular second molars and their relation to mandibular canal in Central Gujarat population using CBCT. Materials and Methods: In this retrospective study 260 CBCT volumes from 5 different CBCT centres in Central Gujarat region were collected between November 2020 till May 2021. The parameters of the second mandibular molars assessed were: Vertucci’s root canal configuration, number of canals, distance of root apex from mandibular canal, degree of curvature, presence of extra root and C-shaped canal. The association between age and distance from root apex to mandibular canal was evaluated as secondary outcome. Chi- square test was used to analyse the relationship between the distance of the mandibular molar from the mandibular canal and age, a p-value of &lt; 0.05 was judged statistically significant. Data were statistically analysed using IBM SPSS Version 21.0. Results: 3 canals were discovered in 73.8% of mandibular second molars, with Type II and Type I root canal configurations in the mesial and distal roots, respectively. With a mean curvature of 21.880, the incidence of C-shaped and Radix canal topologies was determined to be 5.3 percent and 6%, respectively. The average distance of mesial and distal roots from the mandibular canal was 3.04 and 2.78 respectively which decreased with age. The average distance between root of the tooth and mandibular canal is more in males than females and as the age advances the distance increases. Conclusion: In Central Gujarat population, mesial root of mandibular second molar shows Vertucci’s type II canal configuration while distal root presented with type I. C shaped canal configuration with fused roots and Radix Entomolaris was seen in (5.4% and 2.3% respectively). Additionally, as the age advances the distance of root apex from mandibular canal increases.

Mesiodens with Supernumerary Root in a Non Syndromic Child: A Rare Case with Unusual Morphology and its Management

Supernumerary teeth, also known as hyperdontia, are an odontostomatologic aberration characterised by the presence of an excessive number of teeth. They are divided into four categories based on their shapes and sizes: conical, tuberculate, supplementary and odontomes. The most typical location for mesiodens is the palatal midline between the two maxillary central incisors. Mesiodens is common with incidence of occurrence being 0.3-0.8% for primary teeth and 0.15-3.8% for permanent teeth. A supernumerary root is characterised as the existence of an extra root than the typical number, but a mesiodens with a supernumerary root is a very unusual condition encountered, and its occurrence in children is extremely rare. This unusual morphology is not associated with any syndromes. In the present case, the morphology of the crown of mesiodens was found to be conical in shape both clinically and radiographically, but on extraction of mesiodens unusual root morphology with a supernumerary root was seen. Variations in the crown morphology where the crown of mesiodens had five lobes that was separated by developmental grooves and root dilacerations have been noted. However, no case of mesiodens with a supernumerary root has been reported in the literature by far and this paper attempts towards it. Therefore, the present case emphasises on the importance of considering the morphological variations prior to the onset of the treatment. So, hereby authors present a eight-year-old female with rare and unusual case with a mesiodens with a supernumerary root and its management.

Early sensing of phosphate deprivation triggers the formation of extra root cap cell layers via SOMBRERO through a process antagonized by auxin signaling.

The role of the root cap in the plant response to phosphate deprivation has been scarcely investigated. Here we describe early structural, physiological and molecular changes prior to the determinate growth program of the primary roots under low Pi and unveil a critical function of the transcription factor SOMBRERO in low Pi sensing. Mineral nutrient distribution in the soil is uneven and roots efficiently adapt to improve uptake and assimilation of sparingly available resources. Phosphate (Pi) accumulates in the upper layers and thus short and branched root systems proliferate to better exploit organic and inorganic Pi patches. Here we report an early adaptive response of the Arabidopsis primary root that precedes the entrance of the meristem into the determinate developmental program that is a hallmark of the low Pi sensing mechanism. In wild-type seedlings transferred to low Pi medium, the quiescent center domain in primary root tips increases as an early response, as revealed by WOX5:GFP expression and this correlates with a thicker root tip with extra root cap cell layers. The halted primary root growth in WT seedlings could be reversed upon transfer to medium supplemented with 250 µM Pi. Mutant and gene expression analysis indicates that auxin signaling negatively affects the cellular re-specification at the root tip and enabled identification of the transcription factor SOMBRERO as a critical element that orchestrates both the formation of extra root cap layers and primary root growth under Pi scarcity. Moreover, we provide evidence that low Pi-induced root thickening or the loss-of-function of SOMBRERO is associated with expression of phosphate transporters at the root tip. Our data uncover a developmental window where the root tip senses deprivation of a critical macronutrient to improve adaptation and surveillance.

METHODS TO STUDY ROOT CANAL ANATOMY: A SYSTEMATIC REVIEW

Introduction: A variety of methods has been used to study the root canal anatomy. Before radiography became rmly established in dental practice, techniques such as injection-moulded models, diaphanization, and sectioning were used to study the internal anatomy of teeth. Twodimensional radiography was a convenient method to study the root canal anatomy, but it provided limited information due to distortion, superimposition, and lack of 3-dimensional information. Cone beam computed tomography, and more recently micro-CT have been used in most of the recent studies on root canal anatomy as they are non-invasive and provide multiplanar data. Each of these methods has its own merits and knowing when to choose which method whilst planning a study is important. Methods: The systematic review was registered in PROSPERO. Three electronic databases were accessed, and a hand search was performed in peer-reviewed journals in endodontics. Studies that met the pre-dened inclusion and exclusion criteria were selected or rejected, respectively. The screened articles were subjected to Risk of Bias (ROB) assessment for evaluation of their scientic merit. Results: The selected studies included data from at least 288478 teeth studied, of which, 206270 teeth were studied by CBCT, 30980 teeth were studied by clearing technique, 3616 teeth were studied by sectioning, 9027 teeth were studied by Micro CT, and 1191 teeth were studied by resin or plastic inltration. The commonest parameters studied were canal morphology, presence as well as morphology of MB2 canals in maxillary molars, C-shaped canal morphology in mandibular molars, presence of extra roots and canals, isthmuses, and racial characterisation of the study population. Conclusion: With the advent of 3-dimensional radiographic techniques such as CBCT and micro-CT, these methods have become the mainstay of root canal anatomy studies, especially as these techniques have become less expensive and more widely available. Certain techniques such as clearing are relevant even today as they provide excellent details on the intricacies of the canal system. Depending on the study characteristic to be studied, the appropriate method must be employed.

Worldwide Assessment of the Mandibular First Molar Second Distal Root and Root Canal: A Cross-sectional Study with Meta-analysis

IntroductionThis study assessed the prevalence of radix entomolaris and 2 canals at the distal aspect of mandibular first molars among different geographic regions by means of cone-beam computed tomographic imaging. MethodsPrecalibrated observers from 23 worldwide geographic locations followed a standardized screening protocol to assess 5750 cone-beam computed tomographic images of mandibular first molars (250 per region), gathering demographic data and recording the presence of radix entomolaris and a second canal at the distal aspect of teeth. Intra- and interrater reliability tests were conducted and comparisons among groups were performed using proportions and odds ratio forest plots. The significance level was set at 5%. ResultsThe results of intra- and interrater tests were above 0.79. The prevalence of radix entomolaris varied from 0.9% in Venezuela (95% confidence interval [CI], 0%–1.9%) to 22.4% in China (95% CI, 17.2%–27.6%). Regarding the proportion of a second distal canal, it ranged from 16.4% in Venezuela (95% CI, 11.8%–21.0%) to 60.0% in Egypt (95% CI, 53.9%–66.1%). The East Asia subgroup was associated with a significantly higher prevalence of an extra distolingual root, whereas the American subgroup, the American native ethnic group, and elderly patients were linked to significantly lower percentages of a second canal at the distal aspect of teeth. No significant differences were noted between male or female patients. ConclusionsThe overall worldwide prevalence rates of radix entomolaris and a second canal at the distal aspect of the mandibular first molar were 5.6% and 36.9%, respectively. The East Asia geographic region and Asian ethnic group had a higher prevalence of a second distal root.

Extra canal in permanent maxillary first molar in patients undergoing root canal treatment at a tertiary care dental hospital, Nepal

Background: Permanent maxillary first molar normally has three root canals but it can have extra root canals for which several studies were done in many parts of the globe. However, this type of study to explore extra canal is lagging in the context of Nepal. Objectives: The objective was to determine the percentage of extra canal in permanent maxillary first molar in patients undergoing root canal treatment and to compare the same between male and female. Methods: The descriptive cross-sectional study was conducted in the department of conservative dentistry and endodontics of People’s Dental College and Hospital from 20th December 2019 to 20th December 2020 after receiving ethical approval from Nepal Health Research Council on 18th December 2019 (ERB protocol No 888/2019) . One hundred and eighty permanent maxillary first molar teeth without root canal calcification were enrolled. Convenient sampling was done. Access opening was done and all canal orifices were located and recorded. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 22.0 with frequency table. Chi-square test was used for inferential statistics. Results: Out of 180 teeth, extra canals were present in 44(24.4%) having more numbers in male than in females. Extra canal was present in the mesiobuccal root. Conclusion: Extra canal in the permanent maxillary first molar is present in Nepalese population with greater number in male than in female. Thus, exploration of the pulp chamber in search of an extra canal is necessary to prevent failure of root canal treatment.

Root canal morphology and variations in mandibular second molars: an in vivo cone-beam computed tomography analysis

BackgroundThe purpose of this study was to determine the anatomical variations of the root canal system of mandibular second molars using cone-beam computed tomography (CBCT).Methods190 mandibular second molars cone-beam computed tomography images were reviewed. The evaluation was performed by a radiologist with endodontic experience and two endodontists trained with CBCT technology. Tooth position, number of root and root canals, C-shaped root canal system configuration, presence of extra root (radix), and radicular grooves were assessed. Data was statistically analyzed using The Chi-square test (α = 0,05) to determine any significant difference between gender and the total number of root and root canals, and any significant difference between gender and root canal anatomical variation.ResultsOverall, 85.5% showed two separated roots, 12.1% a single root, 2.6% three roots or radix. 87.7% showed three root canals, 12.1% two root canals, 2.6% four root canals, and 1.6% a single root canal. 10% showed a single foramen, 75.3% two foramina, 13.6% three foramina and 1% showed four foramina.19.5% showed C-shaped anatomical variation, 51.4% in male patients, 48.6% in female patients. According to Fan classification: C1 13.6% in cervical third, C2 10% in the middle third, C3 17.3% in middle third, 15.5% in apical third, and C4 12.7% in the apical third. Root canals number in these samples were 5.4% a single canal, 21.6% two canals, 70.3% three canals, and 2.7% four canals. The root showed 46% with one foramen, 46% two foramina, and 8% three foramina. Radicular grooves 83.3% were found in the lingual area and 16.2% towards the buccal area.ConclusionsThe most prevalent anatomic presentation of the evaluated sample was a mandibular second molars with two roots, three root canals, and two apical foramina. Their variation was C-shaped root canals and Radix Paramolaris.

Thecal Sac Contouring as a Surrogate for the Cauda Equina and Intracanal Spinal Nerve Roots for Spine Stereotactic Body Radiation Therapy (SBRT): Contour Variability and Recommendations for Safe Practice

To present interobserver variability in thecal sac (TS) delineation based on contours generated by 8 radiation oncologists experienced in spine stereotactic body radiation therapy and to propose contouring recommendations to standardize practice. In the setting of a larger contouring study that reported target volume delineation guidelines specific to sacral metastases, 8 academically based radiation oncologists with dedicated spine stereotactic body radiation therapy programs independently contoured the TS as a surrogate for the cauda equina and intracanal spinal nerve roots. Uniform treatment planning simulation computed tomography datasets fused with T1, T2, and T1 post gadolinium magnetic resonance imaging for each case were distributed to each radiation oncologist. All contours were analyzed and agreement was calculated using both Dice similarity coefficient and simultaneous truth and performance level estimation with kappa statistics. A fair level of simultaneous truth and performance level estimation agreement was observed between practitioners, with a mean kappa agreement of 0.38 (range, 0.210.55) and the mean Dice similarity coefficient (± standard deviation, with range) was 0.43 (0.36 ± 0.1 to -0.53 ±0.1). Recommendations for a reference TS contour, accounting for the variations in practice observed in this study, include contouring the TS to encompass all the intrathecal spinal nerve roots, and caudal to the termination of the TS, the bony canal can be contoured as a surrogate for the extra thecal nerves roots that run within it. This study shows that even among high-volume practitioners, there is a lack of uniformity when contouring the TS. Further modifications may be required once dosimetric data on nerve tolerance to ablative doses, and pattern of failure analyses of clinical data sets using these recommendations, become available. The contouring recommendations were designed as a guide to enable consistent and safe contouring across general practice.

Occurrence of Extra Roots in Permanent Mandibular Molars: A Cone Beam Computed Topography Study

Introduction: Permanent mandibular first and second molars may display extra roots namely radix entomolaris and radix paramolaris which may have implications in endodontic treatment outcome, if missed.&#x0D; Objective: To evaluate the occurrence of extra roots in permanent mandibular first and second molars in a sample of Nepalese population.&#x0D; Methods: This analytical cross-sectional study was done at Dhulikhel hospital. Convenience sampling technique was utilised for data collection of 773 CBCT images. Images from June 2018 to June 2020 were retrospectively screened for presence of fully erupted bilateral mandibular first and second molars. Presence of extra roots were recorded and laterality, gender, and racial variations were analysed by Fisher’s exact test and Chi-square test using SPSS v.20.&#x0D; Results: For mandibular first molars, out of 517 patients, 65 (11.38%) had radix entomolaris: 38 (13.2%) female and 27 (9.54%) male. Among 38 females; occurrence was 21 (7.3%) bilateral, 16 (5.56%) unilateral right and 1 (0.34%) unilateral left side. Likewise, among 27 males, the occurrence was 15 (5.3%) bilateral, 6 (2.1%) unilateral right and 6 (2.1%) unilateral left side. Regarding races, 50 (14.6%) were Mongoloids and 15 (6.6%) were Aryans. No radix paramolaris was found in mandibular first molars. For mandibular second molars, out of 623 patients, radix entomolaris and paramolaris were observed in 0.8% and 0.48% respectively.&#x0D; Conclusion: The overall occurrence of radix entomolaris in mandibular first and second molars was found to be 11.38% and 0.8%, respectively. Practitioners should be aware of these unusual variations to avoid iatrogenic mishap due to missed canal.

Permanent maxillary first molar with a single root and a single canal diagnosed with cone-beam computed tomography scanning: Case report

Failure of endodontic treatment most commonly occurs due to inability of the clinician to locate the extra root and canal present; however, at times, there could also be a fewer number of roots and canals present, especially in molar teeth. A 33-year-old healthy female reported with a chief complaint of tooth pain in her upper left first molar. Clinical examination revealed a fractured restoration and deep proximal carious lesion of the tooth. The tooth was tender on percussion and negative to thermal and electric pulp testing. Radiographic examination revealed a single root and a single canal. A diagnosis of asymptomatic irreversible pulpitis with symptomatic apical periodontitis was made. Nonsurgical endodontic treatment was performed. The patient was asymptomatic at a 6-month follow-up with no abnormalities detected radiographically. The use of cone-beam computed tomography scan was very helpful in confirming the root and canal morphology of the treated tooth.

Nonsurgical re-treatment of a twin-rooted maxillary lateral incisor

An accurate diagnosis of the anatomy of the root canal system is a prerequisite for successful endodontic treatment. Morphological variations or additional roots/root canal should always be expected. These variations should be strongly considered before starting any endodontic treatment using various diagnostic aids for better outcome therapy. Nonsurgical endodontic re-treatment of a painful twin-rooted maxillary lateral incisor tooth of a 40-year-old female was carried out due to improper diagnosis of the extra root. The clinical examination and radiographic analysis confirmed the diagnosis of previously treated/necrotic pulp and symptomatic apical periodontitis. The patient remained asymptomatic at 6-month follow-up both clinically and radiographically. The case report emphasized on the need for clinicians to be extra careful while treating such teeth and use of cone-beam computed tomography for their diagnosis and management.

Endodontic treatment of a mandibular first molar with radix entomolaris: A case series

Aim: A complete knowledge on the root canal anatomy and morphology is a basic prerequisite for the successful endodontic treatment. Successful endodontic treatment depends on locate all the canals and proper chemomechanical preparation followed by obturation with proper hermetic seal. Failure may occur due to incomplete knowledge and unusual tooth morphology. Mandibular molars may have an extra root when located lingually called radix entomolaris or buccally called radix paramolaris. The successful treatment depend upon the complete Knowledge abnormal root canal morphology. Case Reports: in this article describe three cases of multirooted mandibular first molar and their successful endodontic treatment. Conclusions: For successful endodontic treatment A clinician should have complete knowledge of normal and abnormal anatomy of mandibular first molar and as well as use of recent tool of endodontics like computed tomography and the operating microscope Keywords: Endodontic treatment, Radix entomolaris

A case report on non surgical management of rarely found maxillary first molar with four roots

Endodontic mishaps are very unfortunate and most of the time iatrogenic Causes include inadequate knowledge of radicular morphology and some are due to the negligence of the dental surgeon. Maxillary first molar having three roots and three distinct canals is normal anatomical finding but presence of fourth root with a patent root canal is rare phenomenon to found in routine endodontic practice. Present case report discusses successful non surgical root canal treatment of maxillary first molar with a exceptional root canal anatomy of four separated roots. Invariably maxillary first molar has most complicated root canal anatomy. Most commonly found variation in maxillary molar are presence of two canals i.e.MB1 AND MB2 in mesiobuccal root and accessory canals in the area of furcation. Extra root or fourth root is a rare finding and least documented. This case report explains the successful root canal treatment of first maxillary molar with four distinct roots and four canals. Access cavity modified according to root canal anatomy, cleaning and shaping done with rotary instruments and obturation done with the help of calcium hydroxide based sealer. Keywords: Four Roots, Endodontically, Irreversible Pulpitis, Heat Test, Periapical

Endodontic management of mandibular first molar with radix endomolaris &amp; five canals: A case report

The knowledge of variations in root canal morphology significantly affects the success of endodontic treatment. This article presents the endodontic management of a unique case of mandibular molar with an additional distolingual root with two canals and radix endomolaris which is quite uncommon. Mandibular molars can sometimes present a variation called radix endomolaris, wherein the tooth has an extra root attached to its lingual aspect. Accurate diagnosis and careful application of clinical endodontic skill can favorably alter the prognosis of treatment. Keyword: Radix Endomolaris.