Prevalence of radix entomolaris in mandibular first molars by cone-beam computed tomography in a southern Chilean sub-population / Prevalencia de radix entomolaris en primeros molares mandibulares usando tomografía computarizada cone-beam en una subpoblación del sur de Chile

SUMMARY: The aim of this of this study was to evaluate the prevalence and morphology of radix entomolaris (RE) in the mandibular first molar (MFM) in a southern Chilean sub-population by cone-beam computed tomography (CBCT). Two hundred ten CBCT images of MFM were analysed. To detect the presence of RE, the observation and measurements were standardised, advancing 1 mm to apical from the floor of the pulp chamber to the most apical zone of the tooth. The data were analyzed using descriptive statistics, with a value of P < 0.05 being statistically significant. The prevalence of a third root in the permanent MFM was 5.7 % (12/210). The incidence of RE was the same in male patients (2.9 %) as in female patients (2.9 %) (p=0.324). The occurrence of an RE in the left MFM was 7.3 % (3/41 patients) for male patients and 4.5 % (3/66) for female patients (p=0.398). The right MFM in male patients had an incidence of 8.1 % (3/37) and 4.5 % (3/66) for female patients (p=0.340). When the presence of an RE was compared between the left (5.6 %) and right side (5.8 %), no statistically significant differences were found (p=0.998). The frequency of bilateral three-rooted MFM was 71.43 % (5/7) and 28.57 % (2/7) were unilateral. The prevalence of RE in MFM in a southern Chilean sub-population was 5.7 %. The occurrence was bilateral in the majority of cases and no significant differences were observed by sex or side. The commonest type of RE was Type 1 (83.3 %). The use of CBCT can improve the endodontic treatment outcome.

RESUMEN: El objetivo de este estudio fue evaluar la prevalencia y morfología de radix entomolaris (RE) en el primer mo- lar mandibular (MFM) en una subpoblación del sur de Chile mediante tomografía computarizada de haz cónico (CBCT). Se analizaron doscientas diez imágenes CBCT de MFM. Para detectar la presencia de OD se estandarizó la observación y las medidas, avanzando 1 mm apical desde el suelo de la cámara pulpar hasta la zona más apical del diente. Los datos fueron analizados mediante estadística descriptiva, siendo estadísticamente significativo un valor de P < 0,05. La prevalencia de una tercera raíz en el MFM permanente fue de 5,7 % (12/210). La incidencia de ER fue la misma en pacientes masculinos (2,9 %) que en pacientes femeninas (2,9 %) (p=0,324). La aparición de un ER en el MFM izquier- do fue del 7,3 % (3/41 pacientes) para los pacientes masculinos y del 4,5 % (3/66) para las pacientes femeninas (p=0,398). El MFM derecho en pacientes masculinos tuvo una incidencia de 8,1 % (3/ 37) y 4,5 % (3/66) para pacientes femeninos (p=0,340). Cuando se comparó la presencia de un OD entre el lado izquierdo (5,6 %) y derecho (5,8 %), no se encontraron diferencias estadísticamente significativas (p=0,998). La frecuencia de MFM de tres raíces bilaterales fue 71,43 % (5/7) y 28,57 % (2/7) fueron unilaterales. La prevalencia de RE en MFM en una subpoblación del sur de Chile fue de 5,7 %. La presentación fue bilateral en la mayoría de los casos y no se observaron diferencias significativas por sexo o lado. El tipo de ER más frecuente fue el tipo 1 (83,3 %). El uso de CBCT puede mejorar el resultado del tratamiento endodóntico.

The Radix Entomolaris and Paramolaris: A Review and Case Reports with Clinical Implications

Normally, the permanent mandibular first molar has two roots, mesial and distal. However, mandibular molars may have anadditional root located either buccally (radix paramolaris) or lingually (radix entomolaris [RE]). Understanding of the presence ofan additional root and its root canal, anatomy is essential for successful treatment outcome. The aim of this paper is to reviewthe prevalence and morphology of RE and to present two cases of permanent mandibular first molars with an additional thirdroot (RE) in the Indian population. In this study, we did a clinical investigation of two cases; one case of successful endodonticmanagement of permanent mandibular first molar characterized as RE, whereas the second one is a presentation of a case ofsevere bone loss around permanent first molar with an additional third root. The presence of an additional third root in permanentmandibular first molars may affect the prognosis of the tooth if it is misdiagnosed. Thus, an accurate diagnosis and thoroughunderstanding of variation in root canal anatomy are essential for treatment success.

The prevalence of radix molaris in the mandibular first molars of a Saudi subpopulation based on cone-beam computed tomography

OBJECTIVES: The purpose of this study was to determine the incidence of radix molaris (RM) (entomolaris and paramolaris) in the mandibular first permanent molars of a sample Saudi Arabian subpopulation using cone-beam computed tomography (CBCT).MATERIALS AND METHODS: A total of 884 CBCT images of 427 male and 457 female Saudi citizens (age 16 to 70 years) were collected from the radiology department archives of 4 dental centers. A total of 450 CBCT images of 741 mature mandibular first molars that met the inclusion criteria were reviewed. The images were viewed at high resolution by 3 examiners and were analyzed with Planmeca Romexis software (version 5.2).RESULTS: Thirty-three (4.5%) mandibular first permanent molars had RM, mostly on the distal side. The incidence of radix entomolaris (EM) was 4.3%, while that of radix paramolaris was 0.3%. The RM roots had one canal and occurred more unilaterally. No significant difference in root configuration was found between males and females (p > 0.05). Types I and III EM root canal configurations were most common, while type B was the only RP configuration observed.CONCLUSIONS: The incidence of RM in the mandibular first molars of this Saudi subpopulation was 4.5%. Identification of the supernumerary root can avoid missing the canal associated with the root during root canal treatment.

Radix entomolaris: reporte de caso / Radix entomolaris: report of a case

Una de las variaciones anatómicas que pueden presentar los molares inferiores es una tercera raíz que ha sido denominada radix entomolaris o paramolaris dependiendo de su localización, ya sea lingual o vestibular respectivamente. Conocer las variaciones morfológicas de las piezas dentarias es un requisito fundamental para el éxito del tratamiento endodóntico. El objetivo de este artículo es la presentación de un caso clínico de una paciente con ambos primeros molares inferiores con presencia de radix entomolaris; en la pieza dentaria 4.6 se realizó tratamiento endodóntico y en 3.6 con una lesión endoperiodontal combinada verdadera se decidió su exodoncia (AU)

RADIX ENTOMOLARIS – A Case Series Of Endodontic Management Of A Rare Anatomic Variation In Mandibular Molars.

Radix Entomolarisis the presence of a distolingual supernumerary root found in the first, second, and third mandibular molars .The prevalence of three-rooted mandibular first molars appears to be less than 5% in Eurasian and Asian populations. This case series describes successful endodontic management of a series of seven cases of Radix Entomolaris

Mandibular First Molar with Three Roots and Five Canals: A Case Report.

Clinicians may encounter morphological variations in the form of extra roots and extra root canals. Favorable endodontic treatment requires extensive study of the internal anatomy of teeth. The literature reiterates the incidence of more than three canals in mandibular molar. Radix entomolaris (RE) may complicate the root canal treatment of the tooth if left undiagnosed. The middle mesial canal is more common when compared to the middle distal canal. The combination of RE and three distal canals is a rare occurrence. This case report presents a discussion of root canal therapy in a left mandibular first molar with RE and five root canals.

The Radix Entomolaris : A Rare Entity In Endodontics.

Mandibular molars can have an additional root located lingually (the radix entomolaris) or buccally (the radix paramolaris). If present, an awareness and understanding of this unusual root and its root canal morphology can contribute to the successful outcome of root canal treatment. This report discusses endodontic treatment of one Mandibular molar with a radix entomolaris or paramolaris, both of which are rare macrostructures in the Caucasian population. The prevalence, the external morphological variations and internal anatomy of the radix entomolaris and paramolaris are described. Avoiding procedural errors during endodontic therapy demand an adapted clinical approach to diagnosis and root canal treatment.

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

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.

Radix entomolaris: análisis de la frecuencia y el grado de curvatura radicular en una población de la República Argentina / Radix entomolaris: analysis of the frequency and degree of root curvature in an Argentinian population

Objetivo: evaluar la frecuencia de radix entomolaris (RE) y el grado y la ubicación de la curvatura en primeros molares inferiores, en una población de la República Argentina. Materiales y métodos: de un lote de 1123 piezas dentarias extraídas se separaron y analizaron 342 primeros molares inferiores. Se consiguió el nro. de aquellos que presentaban RE y se analizó su frecuencia. Posteriormente, se hicieron radiografías de la muestra y se analizó el grado de la curvatura y su ubicación. Resultados: se registró RE en el 6.72 por ciento de la muestra. El ángulo de curvatura promedio fue de 29,97º (11,99º); en el 78 por ciento de los casos (P<0,5). Conclusión: la frecuencia y el grado de la curvatura de la re son datos que el clínico debería conocer y es preciso tener en cuenta que suelen estar enmascarados en las radiografías

Clinical Management Of Radix Entomolaris And Radix Paramolaris In Endodontics- Case Reports.

Treatment of mandibular molars have always kept the endodontist sharp and alert as it is one of the teeth that show variations in its external and internal morphology to the extreme. This reaches its epitome in the presence of an additional root located lingually (the radix entomolaris) or buccally (the radix paramolaris). When present an awareness and understanding of this unusual root and its root canal morphology contributes to the successful outcome of root canal treatment. This report discusses endodontic treatment of two mandibular molars with a radix entomolaris or paramolaris. The prevalence, the external morphological variations and internal anatomy of the radix entomolaris and paramolaris are described.

The Radix Entomolaris – An Endodontic Challenge : Case Reports.

Mandibular molars can have an additional root located lingually (the radix entomolaris) or buccally (the radix paramolaris). If present, an awareness and understanding of this unusual root and its root canal morphology can contribute to the successful outcome of root canal treatment. This report discusses endodontic treatment of three mandibular molars with a radix entomolaris. The prevalence, the external morphological variations and internal anatomy of the radix entomolaris and paramolaris are described.

Endodontic Management Of Radix Entomolaris - Two Case Reports.

A mandibular first molar with two distal roots is an interesting example of anatomic variation. This paper describes 2 case reports of mandibular first molar with three roots (one mesial and two distal) and four canals (two in mesial and one in each distobuccal and distolingual root). The canals were shaped with protaper rotary files and irrigated with 2.5% sodium hyochlorite and 0.2 %w/v of chlorhexidine gluconate and normal saline as the final irrigant. The prevalence, the external morphological variations and internal anatomy of the radix entomolaris and paramolaris are described.