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Endodontic management of a mandibular second molar with radix entomolaris: a case report

  • Hannah, Rosaline (Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Sri Ramachandra University) ;
  • Kandaswamy, Deivanayagam (Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Sri Ramachandra University) ;
  • Jayaprakash, Nachimuthu (Department of Conservative Dentistry and Endodontics, JKK Nataraja Dental College)
  • Received : 2013.10.18
  • Accepted : 2014.01.30
  • Published : 2014.05.30

Abstract

The presence of radix entomolaris (RE) in a mandibular first molar is a common occurrence in certain ethnic groups, but the presence of RE in a mandibular second molar is a rare occurrence. In the present case, RE was identified from preoperative radiographs and confirmed using cone-beam computed tomography (CBCT). The access cavity was modified to locate the RE. Cleaning and shaping were performed with nickel-titanium rotary instruments. Obturation was completed with gutta-percha cones using AH Plus (Dentsply Detrey GmbH) as sealer. From the CBCT axial images, the RE was determined to have a Type III curvature by the De Moor classification, Type B separate RE by the Carlsen and Alexandersen classification, and radiographically, a Type i image by the Wang classification. The presence of RE in the mandibular second molar makes it essential to anticipate and treat the distolingual root canal. This case report highlights the usefulness of CBCT for assessing RE in the mandibular second molar, which can help the clinician in making a confirmatory diagnosis and assessing the morphology of the root canal.

Keywords

References

  1. Schumacher C. Endodontic treatment of a mandibular first molar with radix entomolaris: a case report. ENDO (Lond Engl) 2008;2:301-304.
  2. Carabelli G. Systematisches Handbuch Der Zahnheikunde. 2nd ed. Vienna: Braumuller and Seidel; 1844. p114.
  3. Calberson FL, De Moor RJ, Deroose CA. The radix entomolaris and paramolaris: clinical approach in endodontics. J Endod 2007;33:58-63. https://doi.org/10.1016/j.joen.2006.05.007
  4. Manning SA. Root canal anatomy of mandibular second molars. Part I. Int Endod J 1990;23:34-39. https://doi.org/10.1111/j.1365-2591.1990.tb00800.x
  5. Neelakantan P, Subbarao C, Subbarao CV, Ravindranath M. Root and canal morphology of mandibular second molars in an Indian population. J Endod 2010;36:1319-1322. https://doi.org/10.1016/j.joen.2010.04.001
  6. Garg AK, Tewari RK, Kumar A, Hashmi SH, Agrawal N, Mishra SK. Prevalence of three-rooted mandibular permanent first molars among the Indian population. J Endod 2010;36:1302-1306. https://doi.org/10.1016/j.joen.2010.04.019
  7. Turner CG 2nd. Three-rooted mandibular first permanent molars and the question of American Indian origins. Am J Phys Anthropol 1971;34:229-241. https://doi.org/10.1002/ajpa.1330340207
  8. Loh HS. Incidence and features of three-rooted permanent mandibular molars. Aust Dent J 1990;35:434-437. https://doi.org/10.1111/j.1834-7819.1990.tb05426.x
  9. de Souza-Freitas JA, Lopes ES, Casati-Alvares L. Anatomic variations of lower first permanent molar roots in two ethnic groups. Oral Surg Oral Med Oral Pathol 1971;31:274-278. https://doi.org/10.1016/0030-4220(71)90083-1
  10. Skidmore AE, Bjorndal AM. Root canal morphology of the human mandibular first molar. Oral Surg Oral Med Oral Pathol 1971;32:778-784. https://doi.org/10.1016/0030-4220(71)90304-5
  11. Steelman R. Incidence of an accessory distal root on mandibular first permanent molars in Hispanic children. ASDC J Dent Child 1986;53:122-123.
  12. Sperber GH, Moreau JL. Study of the number of roots and canals in Senegalese first permanent mandibular molars. Int Endod J 1998;31:117-122. https://doi.org/10.1046/j.1365-2591.1998.00126.x
  13. Tratman EK. Three-rooted lower molars in man and their racial distribution. Br Dent J 1938;64:264-274.
  14. Tachibana H, Matsumoto K. Applicability of X-Ray computerized tomography in endodontics. Endod Dent Traumatol 1990;6:16-20. https://doi.org/10.1111/j.1600-9657.1990.tb00381.x
  15. Nair MK, Nair UP. Digital and advanced imaging in endodontics: a review. J Endod 2007;33:1-6.
  16. Matherne RP, Angelopoulos C, Kulild JC, Tira D. Use of cone-beam computed tomography to identify root canal systems in vitro. J Endod 2008;34:87-89. https://doi.org/10.1016/j.joen.2007.10.016
  17. Song JS, Choi HJ, Jung IY, Jung HS, Kim SO. The prevalence and morphologic classification of distolingual roots in the mandibular molars in a Korean population. J Endod 2010;36:653-657. https://doi.org/10.1016/j.joen.2009.10.007
  18. Schäfer E, Breuer D, Janzen S. The prevalence of threerooted mandibular permanent first molars in a German population. J Endod 2009;35:202-205. https://doi.org/10.1016/j.joen.2008.11.010
  19. Reichart PA, Metah D. Three-rooted permanent mandibular first molars in the Thai. Community Dent Oral Epidemiol 1981;9:191-192. https://doi.org/10.1111/j.1600-0528.1981.tb01053.x
  20. 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;36:990-994. https://doi.org/10.1016/j.joen.2010.02.030
  21. De Moor RJ, Deroose CA, Calberson FL. The radix entomolaris in mandibular first molars: an endodontic challenge. Int Endod J 2004;37:789-799. https://doi.org/10.1111/j.1365-2591.2004.00870.x
  22. 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;37:1063-1068. https://doi.org/10.1016/j.joen.2011.05.017
  23. Carlsen O, Alexandersen V. Radix entomolaris: identification and morphology. Scand J Dent Res 1990; 98:363-373.
  24. Patel S, Dawood A, Whaites E, Pitt Ford T. New dimensions in endodontic imaging: part 1. Conventional and alternative radiographic systems. Int Endod J 2009; 42:447-462. https://doi.org/10.1111/j.1365-2591.2008.01530.x
  25. Karanxha L, Kim HJ, Hong SO, Lee W, Kim PS, Min KS. Endodontic management of a C-shaped maxillary first molar with three independent buccal root canals by using cone-beam computed tomography. Restor Dent Endod 2012;37:175-179. https://doi.org/10.5395/rde.2012.37.3.175
  26. Abella F, Patel S, Duran-Sindreu F, Mercade M, Roig M. Mandibular first molars with disto-lingual roots: review and clinical management. Int Endod J 2012;45:963-978. https://doi.org/10.1111/j.1365-2591.2012.02075.x
  27. Lee MH, Ha JH, Jin MU, Kim YK, Kim SK. Endodontic treatment of maxillary lateral incisors with anatomical variations. Restor Dent Endod 2013;38:253-257. https://doi.org/10.5395/rde.2013.38.4.253

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