Unveiling radix entomolaris: A case report and literature review on mandibular first molar anatomical variation

The mandibular first molar is renowned for its typical root anatomy, characterized by a mesial and distal root. Nonetheless, anatomical variations may exist, demanding a meticulous approach during endodontic procedures. The presence of an extra lingual root distally, termed radix entomolaris (RE), poses challenges to successful root canal treatment. Accurate interpretation of radiographs and precise angulations are crucial for identifying the pulp chamber and root anatomy. This study aims to present a compelling case of a mandibular first molar with an additional distolingual root (RE) and to conduct a thorough survey of existing literature to determine the incidence of this anatomical feature. The objective is to emphasize the significance of recognizing and understanding this unusual root and its canal morphology in ensuring the efficacy of root canal treatment. The failure to identify radix entomolaris (RE) can significantly impact the prognosis of endodontic treatment. Awareness and comprehension of this anatomical variation contribute to the successful outcome of root canal procedures in mandibular first molars. Proper identification, treatment planning, and meticulous execution are imperative when faced with such variations.