Case Report
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Year 2025, Volume: 26 Issue: 1, 19 - 23, 28.03.2025

Abstract

References

  • Abella F, Mercadé M, Duran-Sindreu F, Roig M. Managing severe curvature of radix entomolaris: three-dimensional analysis with cone beam computed tomography. Int Endod J. 2011;44(9):876-885. doi:10. 1111/j.1365-2591.2011.01898.x
  • Hatipoğlu FP, Mağat G, Hatipoğlu Ö, et al. Assessment of the prevalence of radix entomolaris and distolingual canal in mandibular first molars in 15 countries: a multinational cross-sectional study with meta-analysis. J Endod. 2023;49(10):1308-1318. doi:10.1016/j.joen.2023.06.011
  • Gulabivala K, Opasanon A, Ng YL, Alavi A. Root and canal morphology of Thai mandibular molars. Int Endod J. 2002;35(1):56-62. doi:10.1046/j. 1365-2591.2002.00452.x
  • Zhang R, Wang H, Tian YY, Yu X, Hu T, Dummer PM. Use of cone-beam computed tomography to evaluate root and canal morphology of mandibular molars in Chinese individuals. Int Endod J. 2011;44(11):990-999. doi:10.1111/j.1365-2591.2011.01904.x
  • Abella F, Patel S, Durán-Sindreu F, Mercadé M, Roig M. Mandibular first molars with disto-lingual roots: review and clinical management. Int Endod J. 2012;45(11):963-978. doi:10.1111/j.1365-2591.2012.02075.x
  • Pereira B, Martins JNR, Baruwa AO, et al. Association between endodontically treated maxillary and mandibular molars with fused roots and periapical lesions: a cone-beam computed tomography cross-sectional study. J Endod. 2020;46(6):771-777. doi:10.1016/j.joen.2020.03. 003
  • Martins JNR, Nole C, Ounsi HF, et al. Worldwide assessment of the mandibular first molar second distal root and root canal: a cross-sectional study with meta-analysis. J Endod. 2022;48(2):223-233. doi:10. 1016/j.joen.2021.11.009
  • Calberson FL, De Moor RJ, Deroose CA. The radix entomolaris and paramolaris: clinical approach in endodontics. J Endod. 2007;33(1):58-63. doi:10.1016/j.joen.2006.05.007
  • De Moor RJ, Deroose CA, Calberson FL. The radix entomolaris in mandibular first molars: an endodontic challenge. Int Endod J. 2004; 37(11):789-799. doi:10.1111/j.1365-2591.2004.00870.x
  • Gulabivala K, Ng YL. Factors that affect the outcomes of root canal treatment and retreatment-A reframing of the principles. Int Endod J. 2023;56(Suppl 2):82-115. doi:10.1111/iej.13897
  • Meirinhos J, Martins J, Pereira B, Baruwa A, Ginjeira A. Prevalence of lateral radiolucency, apical root resorption and periapical lesions in portuguese patients: a CBCT cross-sectional study with a worldwide overview. Eur Endod J. 2021;6(1):56-71. doi:10.14744/eej.2021.29981
  • Gu Y, Lu Q, Wang H, Ding Y, Wang P, Ni L. Root canal morphology of permanent three-rooted mandibular first molars-part I: pulp floor and root canal system. J Endod. 2010;36(6):990-994. doi:10.1016/j.joen.2010. 02.030
  • Kim KR, Song JS, Kim SO, Kim SH, Park W, Son HK. Morphological changes in the crown of mandibular molars with an additional distolingual root. Arch Oral Biol. 2013;58(3):248-253. doi:10.1016/j.archoralbio.2012.07.015
  • Wang Q, Yu G, Zhou XD, Peters OA, Zheng QH, Huang DM. Evaluation of X-Ray projection angulation for successful radix entomolaris diagnosis in mandibular first molars in vitro. J Endod. 2011;37(8):1063-1068. doi:10.1016/j.joen.2011.05.017
  • Różyło TK, Piskórz MJ, Różyło-Kalinowska IK. Radiographic appearance and clinical implications of the presence of radix entomolaris and radix paramolaris. Folia Morphol (Warsz). 2014;73(4):449-454. doi: 10.5603/FM.2014.0067
  • Baruwa AO, Martins JNR, Pereira B, et al. Prevalence of periapical lesions, root canal treatments and restorations in teeth adjacent to implant- or tooth-supported crowns: a multi-centre cross-sectional study. Int Endod J. 2022;55(1):30-37. doi:10.1111/iej.13651
  • Michetti J, Maret D, Mallet JP, Diemer F. Validation of cone beam computed tomography as a tool to explore root canal anatomy. J Endod. 2010;36(7):1187-1190. doi:10.1016/j.joen.2010.03.029
  • Nogueira FC, Pires MD, Baruwa AO, Pereira B, Martins JN, Ginjeira A. Root canal treatment of a maxillary second molar with four mesiobuccal root canals-a case report. Rev Port Estomatol Med Dent Cir Maxilofac. 2022;63(1):35-40. doi:10.24873/j.rpemd.2022.03.862
  • Chen YC, Lee YY, Pai SF, Yang SF. The morphologic characteristics of the distolingual roots of mandibular first molars in a Taiwanese population. J Endod. 2009;35(5):643-645. doi:10.1016/j.joen.2009.01.020
  • Piresa MD, Baruwaa AO, Martinsa J, Quaresmaa SA, da Costaa RP, Ginjeiraa A. Endodontic management of developmental anomalies: conservation of invaginated tissues in type II dens invaginatus-case series. Rev Port Estomatol Med Dent Cir Maxilofac. 2019;60:18-26. doi: 10.24873/j.rpemd.2019.03.442
  • Berutti E, Negro AR, Lendini M, Pasqualini D. Influence of manual preflaring and torque on the failure rate of ProTaper rotary instruments. J Endod. 2004;30(4):228-230. doi:10.1097/00004770-200404000-00011

Endodontic management of radix entomolaris in mandibular first molar teeth: a case series

Year 2025, Volume: 26 Issue: 1, 19 - 23, 28.03.2025

Abstract

The success of endodontic treatment depends on a correct understanding of root canal anatomy, identification of anatomical variations, and correct canal positioning. Mandibular molars, which usually have two roots, may harbor an additional root, such as the radix entomolaris (RE), incompatible with this expected anatomy. The location of this variant root, especially close to the distolingual root, can complicate the endodontic procedure. This case series provides important insights into the clinical management of RE variation based on three cases with RE. The clinical evaluation, diagnosis, and root canal treatment procedures are presented. The teeth were asymptomatic at follow-up examinations, and radiographic examinations revealed normal/healthy periapical status. Endodontic specialists and endodontic treating physicians must take a careful and conscious approach to the presence of additional roots in mandibular molars during root canal treatment processes. Proper understanding and handling anatomical variations such as RE is a critical factor in the success of root canal treatment.

References

  • Abella F, Mercadé M, Duran-Sindreu F, Roig M. Managing severe curvature of radix entomolaris: three-dimensional analysis with cone beam computed tomography. Int Endod J. 2011;44(9):876-885. doi:10. 1111/j.1365-2591.2011.01898.x
  • Hatipoğlu FP, Mağat G, Hatipoğlu Ö, et al. Assessment of the prevalence of radix entomolaris and distolingual canal in mandibular first molars in 15 countries: a multinational cross-sectional study with meta-analysis. J Endod. 2023;49(10):1308-1318. doi:10.1016/j.joen.2023.06.011
  • Gulabivala K, Opasanon A, Ng YL, Alavi A. Root and canal morphology of Thai mandibular molars. Int Endod J. 2002;35(1):56-62. doi:10.1046/j. 1365-2591.2002.00452.x
  • Zhang R, Wang H, Tian YY, Yu X, Hu T, Dummer PM. Use of cone-beam computed tomography to evaluate root and canal morphology of mandibular molars in Chinese individuals. Int Endod J. 2011;44(11):990-999. doi:10.1111/j.1365-2591.2011.01904.x
  • Abella F, Patel S, Durán-Sindreu F, Mercadé M, Roig M. Mandibular first molars with disto-lingual roots: review and clinical management. Int Endod J. 2012;45(11):963-978. doi:10.1111/j.1365-2591.2012.02075.x
  • Pereira B, Martins JNR, Baruwa AO, et al. Association between endodontically treated maxillary and mandibular molars with fused roots and periapical lesions: a cone-beam computed tomography cross-sectional study. J Endod. 2020;46(6):771-777. doi:10.1016/j.joen.2020.03. 003
  • Martins JNR, Nole C, Ounsi HF, et al. Worldwide assessment of the mandibular first molar second distal root and root canal: a cross-sectional study with meta-analysis. J Endod. 2022;48(2):223-233. doi:10. 1016/j.joen.2021.11.009
  • Calberson FL, De Moor RJ, Deroose CA. The radix entomolaris and paramolaris: clinical approach in endodontics. J Endod. 2007;33(1):58-63. doi:10.1016/j.joen.2006.05.007
  • De Moor RJ, Deroose CA, Calberson FL. The radix entomolaris in mandibular first molars: an endodontic challenge. Int Endod J. 2004; 37(11):789-799. doi:10.1111/j.1365-2591.2004.00870.x
  • Gulabivala K, Ng YL. Factors that affect the outcomes of root canal treatment and retreatment-A reframing of the principles. Int Endod J. 2023;56(Suppl 2):82-115. doi:10.1111/iej.13897
  • Meirinhos J, Martins J, Pereira B, Baruwa A, Ginjeira A. Prevalence of lateral radiolucency, apical root resorption and periapical lesions in portuguese patients: a CBCT cross-sectional study with a worldwide overview. Eur Endod J. 2021;6(1):56-71. doi:10.14744/eej.2021.29981
  • Gu Y, Lu Q, Wang H, Ding Y, Wang P, Ni L. Root canal morphology of permanent three-rooted mandibular first molars-part I: pulp floor and root canal system. J Endod. 2010;36(6):990-994. doi:10.1016/j.joen.2010. 02.030
  • Kim KR, Song JS, Kim SO, Kim SH, Park W, Son HK. Morphological changes in the crown of mandibular molars with an additional distolingual root. Arch Oral Biol. 2013;58(3):248-253. doi:10.1016/j.archoralbio.2012.07.015
  • Wang Q, Yu G, Zhou XD, Peters OA, Zheng QH, Huang DM. Evaluation of X-Ray projection angulation for successful radix entomolaris diagnosis in mandibular first molars in vitro. J Endod. 2011;37(8):1063-1068. doi:10.1016/j.joen.2011.05.017
  • Różyło TK, Piskórz MJ, Różyło-Kalinowska IK. Radiographic appearance and clinical implications of the presence of radix entomolaris and radix paramolaris. Folia Morphol (Warsz). 2014;73(4):449-454. doi: 10.5603/FM.2014.0067
  • Baruwa AO, Martins JNR, Pereira B, et al. Prevalence of periapical lesions, root canal treatments and restorations in teeth adjacent to implant- or tooth-supported crowns: a multi-centre cross-sectional study. Int Endod J. 2022;55(1):30-37. doi:10.1111/iej.13651
  • Michetti J, Maret D, Mallet JP, Diemer F. Validation of cone beam computed tomography as a tool to explore root canal anatomy. J Endod. 2010;36(7):1187-1190. doi:10.1016/j.joen.2010.03.029
  • Nogueira FC, Pires MD, Baruwa AO, Pereira B, Martins JN, Ginjeira A. Root canal treatment of a maxillary second molar with four mesiobuccal root canals-a case report. Rev Port Estomatol Med Dent Cir Maxilofac. 2022;63(1):35-40. doi:10.24873/j.rpemd.2022.03.862
  • Chen YC, Lee YY, Pai SF, Yang SF. The morphologic characteristics of the distolingual roots of mandibular first molars in a Taiwanese population. J Endod. 2009;35(5):643-645. doi:10.1016/j.joen.2009.01.020
  • Piresa MD, Baruwaa AO, Martinsa J, Quaresmaa SA, da Costaa RP, Ginjeiraa A. Endodontic management of developmental anomalies: conservation of invaginated tissues in type II dens invaginatus-case series. Rev Port Estomatol Med Dent Cir Maxilofac. 2019;60:18-26. doi: 10.24873/j.rpemd.2019.03.442
  • Berutti E, Negro AR, Lendini M, Pasqualini D. Influence of manual preflaring and torque on the failure rate of ProTaper rotary instruments. J Endod. 2004;30(4):228-230. doi:10.1097/00004770-200404000-00011
There are 21 citations in total.

Details

Primary Language English
Subjects Endodontics
Journal Section Olgu Sunumu
Authors

Merve Defişet 0009-0003-6270-8979

Ayşenur Çam 0009-0003-6404-9057

Merve Yeniçeri Özata 0000-0003-3619-3118

Publication Date March 28, 2025
Submission Date February 20, 2025
Acceptance Date March 25, 2025
Published in Issue Year 2025 Volume: 26 Issue: 1

Cite

AMA Defişet M, Çam A, Yeniçeri Özata M. Endodontic management of radix entomolaris in mandibular first molar teeth: a case series. Dicle Dent J. March 2025;26(1):19-23.