The enigma of molar root-incisor malformation: A rare case report and clinical insight

Molar root-incisor malformation (MRIM) is an uncommon developmental anomaly that is defined by an abnormal and incomplete root formation along with clinically normal crown morphology and texture, mostly involving permanent first molars and central incisors. A 13-year-old boy with typical clinical and radiographic features of MRIM, probably the first case in the Indian subcontinent, was treated with endodontic treatment of the maxillary incisor and extraction of the mobile mandibular left first molar. A systemic disease, which needed hospitalization and treatment at 1 month of age, may indicate an involvement of the signaling pathways related to root formation. H & E-stained sections of the extracted specimen were examined histologically to assess the pathological changes in the malformed root and pulpal tissues. The congenital absence of the contralateral maxillary central incisor is new finding and has not been mentioned in the literature. This case, and the novel clinical features, reminds general dental practitioners of the need to be aware of the diagnosis of MRIM and the need for a multidisciplinary treatment approach.