Prevalence of Three-Rooted Mandibular First Molars Among Jordanian Royal Medical Services Patients Using Cone-Beam Computed Tomography

Background Anatomical variations in the mandibular first molars can significantly impact endodontic outcomes. The presence of additional roots, such as the distolingual radix entomolaris (RE) and the mesiobuccal radix paramolaris (RP), complicates endodontic procedures. Traditional radiographs often fail to detect these variations due to their inherent limitations. This study aims to determine the incidence of RE and RP in mandibular first molars using cone-beam computed tomography (CBCT) in a Jordanian population. Methodology A retrospective study was conducted at the Queen Alia Military Hospital, Jordan, involving 1,278 patients who underwent CBCT imaging from January 2019 to January 2023. We included patients aged 18-70 years with bilateral mandibular first molars. A total of 500 CBCT scans were evaluated by two experienced endodontists to assess the presence of a supernumerary third root. Demographic data, including age, sex, and the presence of right-sided, left-sided, or bilateral third roots, were collected and statistically analyzed using the chi-square and Fisher's exact tests. Results The prevalence of a third root was 7.4% on the right side, 3.2% on the left side, and 2.6% bilaterally. A significant association was found between gender and the presence of a right-sided third root (p = 0.027), with a higher prevalence in females (9.9%) compared to males (4.7%). Conclusions The prevalence of this racial anatomical variant was higher in females in the Jordanian population. Clinicians must be aware of this variant. A thorough radiographic examination must be conducted before initiating endodontic procedures to avoid any potential complications.