Management of additional roots in mandibular molars: report of radix entomolaris and radix paramolaris cases

Achieving a favorable outcome after endodontic treatment depends on a clear understanding of tooth anatomy, identification of variations, and precise root canal location. Multi-rooted mandibular molars often deviate from the expected configuration, sometimes featuring additional roots, such as radix entomolaris (RE) and radix paramolaris (RP), posing challenges during treatment. Detecting these variations is challenging due to their proximity to the distal root, and overlooking them can lead to complications. This study presents three cases involving RE and RP and offers insights into their clinical management, encompassing thorough clinical assessment, diagnosis, and root canal treatment. At follow-up examinations, patients were asymptomatic with no radiographic evidence of persistent infection. Therefore, clinicians must be aware and informed about the potential presence of additional roots in mandibular molars during root canal procedures, as understanding and addressing anatomical variations like RE and RP is crucial for achieving favorable outcomes in root canal treatments.