Restorative and endodontic management of an anomalous mandibular molar

Morphologic variations of dental hard tissue should be recognized and considered during restorative procedures. Overlooking anomalies increases the potential for clinical complications. Amalgam was used erroneously in a patient when the presence of a paramolar structure was overlooked. The clinical complications that resulted from overlooking the anomaly led to restorative, endodontic, and periodontal failures. The present report describes the use of conservative endodontics and a cast restoration, taking into account the presence of the paramolar structure, to correct the case.