Asian Journal of Dental Sciences

Radix entomolaris (RE) is an uncommon anatomical variation characterized by the presence of an additional distolingual root in mandibular molars, most frequently the first molar. Its presence poses diagnostic and clinical challenges, especially during endodontic treatment. This case series presents 3 clinical cases of mandibular first molars with RE, emphasizing the importance of accurate diagnosis, modified access preparation, and careful canal negotiation. Radiographic evaluation, including angled periapical radiographs and cone-beam computed tomography (CBCT), played a crucial role in detecting the extra root. All cases were managed using magnification and enhanced illumination to facilitate identification and treatment of the RE canal. Endodontic therapy was completed successfully in all cases, with favorable postoperative outcomes observed during follow-up. This series highlights the necessity for clinicians to be aware of root canal variations such as RE and to adapt their techniques accordingly to ensure successful treatment outcomes.