Endodontic management of a maxillary molar with formation supradentalis: A case report

Anatomic variations may be observed in the crown or in the roots of maxillary molars. In rare instances, crown and root morphology, both show variations. Occurrence of paramolar cusp on the occlusal surface as central cusp or on the buccal surface as parastyle has been frequently reported in maxillary molars. However, presence of paramolar cusp on the palatal surface has not been reported. 'Formation supradentalis' is a condition in which supernumerary cusp is associated with a supernumerary root in a molar. The occurrence of such concomitant corono-radicular morphology is multifactorial, that is primary polygenic with secondary environmental influences. This case reports the diagnosis and endodontic management of Formation-supradentalis that had six cusps and four roots in the maxillary first molar. The tooth exhibited a prominent paramolar palatal cusp and cusp of Carabelli along with a supernumerary palatal root. To the best of author's knowledge, this is the first documentation of endodontic management of Formation supradentalis.