Diagnosis of Bilateral Type-A Radix Para-Molaris on Mandibular First Molars: A Case Report

Successful endodontic treatment of a molar tooth having an additional root whether it is radix para/ento molaris; begins with proper diagnosis. Hence careful examination and assessment of intra oral peri-apical radiographs should be done prior to attempting access opening. These iopa's provide sufficient details regarding presence of additional roots. Mesial or distal cone shift technique could be used to assess according to operator's choice to confirm presence of additional roots. In addition to the intra oral peri-apical radiographs, CBCT evaluation is recommended for the correct diagnosis, as that will help in rendering quality treatment to the patients. Access opening design will require modification in order to accommodate a straight line entry to the additional root (RP or RE). Cleaning and shaping can follow with standard procedures unless there is presence of additional canals in the same root such as mid mesial canal. In such cases, it may be wise not to enlarge the canal with a 6% taper; as it will compromise lot of intra canal dentin and weaken the root. However, once the tooth is successfully treated endodontically; one can proceed to do crown prosthesis of clinician's choice depending on various factors.