Radix Entomolaris (RE)

The Radix Entomolaris is an important and challenging anatomic variation of mandibular first molars, which usually has a severe curvature with a predominantly distolingual location. Three-rooted mandibular first molars deserve special attention during endodontic treatment because the additional root is usually smaller than the mesial and distal roots, can be either separate or partially fused with the other roots, and has a severe curvature in most cases (Gu et al, 2010).

DeMoor classified RE according to the root curvature:

The case presented is from an 85 year old male with a Type III Radix Entomolaris associated with his lower right first molar. The patient had severe Parkinson's Disease which made it difficult to get good imagery. The severe curvature of the RE further complicated the treatment and greatly increased the possibility of instrument separation.

Adequate management of the RE was achieved with hand files, recapitulation and disinfection with YSGG laser energy and obturation with bioceramic sealer and single-cone gutta percha. "Laser recapitulation" ?is the removal of calcifications as well as dentin mud during glide path formation, as well as canal shaping, by recapitulating with laser energy?(NOT with a file!)?