Navigating Complexity in Endodontic Therapy in Children: Case Series on Radix Entomolaris

This case series aims to highlight the identification and management of radix entomolaris (RE), an anatomical variation of the mandibular molar, emphasizing its clinical implications on the development of dentition, occlusion, and endodontic treatment. This anatomical variant can lead to diagnostic challenges, inadequate cleaning, persistent infection, or potential treatment failure if not recognized.

This case series presents three cases of permanent mandibular first molar that had periapical radiolucency and the presence of an additional distal root lingually, which was identified by the same lingual, opposite buccal (SLOB) rule. During endodontic therapy, the additional canal within the RE was successfully located and treated, leading to the resolution of symptoms.

The presence of a RE necessitates thorough preoperative assessment and careful management during endodontic procedures. Awareness of this anatomical variation is critical for successful outcomes of endodontic therapy.

These cases underscore the importance of understanding variations in dental anatomy for effective diagnosis and treatment planning in pediatric endodontics. Enhanced knowledge of such anatomical features can improve clinical outcomes and reduce the likelihood of complications in similar cases.