Three rooted, four canalled mandibular first molar (Radix Entomolaris)

Evaluation of the Frequency and Anatomy of Radix Entomolaris and Paramolaris in Lower Molars by Cone Beam Computed Tomography (CBCT) in Northern Iran, 2020-2021: A Retrospective Study

INTRODUCTION AND OBJECTIVE

The presence of an additional root, known as a radix, in the lower molars is of significant importance in the context of root canal therapy since it has the potential to contribute to treatment failure. Furthermore, it is imperative to take this circumstance into consideration when doing tooth extraction using a radix. The present study investigated the anatomical characteristics and prevalence rates of radix entomolaris and paramolaris in mandibular molars using cone beam computed tomography.

MATERIALS AND METHODS

Cone beam computed tomography scans of the lower molars of 376 patients were processed through Newtom's NNT viewer software. Radix type, radix root canal length, radix root curvature, Vertucci's classification of the canal, and gender of patients were recorded. The results of the research were analyzed with chi-squared.

RESULTS

The prevalence of radix was found to be 0.74%, with entomolaris and paramolaris present in 54.54% and 45.46% of cases, respectively. There was no statistically significant difference between the two variables of radix type and gender, as indicated by a p-value of 0.08. The mean curvature and length of the radix root were measured to be 56.63° and 15.09 mm, respectively. The average root curvature in individuals diagnosed with radix entomolaris and paramolaris was found to be 62.33° and 49.80°, respectively. The study found that the root curvature of entomolaris exhibited a statistically significant difference compared to paramolaris (P=0.031). The mean length of the radix entomolaris and paramolaris roots was found to be 15.50 and 14.60 mm, respectively. There was no statistically significant difference observed in the mean root lengths of the various radix types (P=0.37). According to Vertucci's classification, all radixes were classified as type 1.

CONCLUSION

The investigated population had a low incidence of radix. The curvature of radix entomolaris exhibited a statistically significant increase compared to radix paramolaris. There was no observed correlation between gender and the length of radix roots in relation to the type of radix root.

Variable permanent mandibular first molar: Review of literature

Introduction:

The success of root canal therapy depends on the locations of all the canals, thourough debridement and proper sealing. At times the clinicians are challenged with variations in morphology of root canal. This review article attempts to list out all the variations of permanent mandibular first molar published so for in the literature.

Materials and Methods:

An exhaustive search was undertaken using PUBMED database to identify published literature from 1900 to 2010 relating to the root canal morphology of permanent first molar by using key words. The selected artcles were obtained and reviewed.

Results:

Total ninty seven articles were selected out of which 50 were original article and forty seven were case reports. The incidence of third canal in mesial root was 0.95% to 15%. The incidence of three rooted mandibular first molar was 3% to 33%. Only ninety cases reported with c-shape canal configuration. Incidence of Taurodintism without congenital disorder was very rare.

Conclusion:

The root canal treatment requires proper knowlegde of variations in root canal morphology in order to recognise, disinfect and seal all portal of exit. This can be accomplished with proper diagnosis using newer modes, modification in access preparation, use of operating microscope, enhanced methods of disinfecting and sealing of all canals.

Three-rooted mandibular first molar: A consideration in periodontal therapy

A deep understanding of the relationship between root morphology and periodontal destruction is crucial to successful periodontal care. Most mandibular molars have two roots (one mesial and the other distal) and three canals. The major variant of this tooth type is the presence of an additional third root distally or mesially or a supernumerary lingual root. This article presents a case report of a 14-year-old girl with mandibular first molar having three roots bilaterally which is contributing to the periodontal destruction. There were three walled defect distal to first molar with Grade II furcation involvement distally. Regenerative surgeries were performed and patient was kept under maintenance. The relationship between additional third root and periodontal destruction seldom has been described clearly. This paper has been presented in 34^th national conference at Dharwad.