Awareness of anatomy of root canal and its associated variations is important to ensure successful endodontic treatment. Mandibular first molar generally demonstrates presence of one mesial and distal root with three canals. But in some cases, they depict anatomic variation in terms of number of roots wherein an additional root might be present either buccally [radix paramolaris (RP)] or lingually [radix entomolaris (RE)]. Appropriate diagnosis of such atypical anatomic variation is key to success for root canal therapy. This case report describes endodontic management of a mandibular first molar with radix, variation was identified through clinical examination along with the aid of multiangled radiographs, and was confirmed with the help of a cone-beam computed tomography (CBCT) imaging.
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