I am Mohammed Shawky, member at style italiano endodontics. In this pop lesson i will discuss with you a very important anatomical feature which is the radix entomolaris. Radix entomolaris was first described in 1844 by Carabelli as a supernumerary root located disto-lingually in mandibular molars. Regarding the prevalence of radix entomolaris it has about 13% prevalence in mandibular first molars and about 2% in second molars. Literature showed a very low prevalence in european descendants, but it has a higher incidence among asians, african and caucasian ethnic groups. CBCT studies showed a higher incidence probably due to the advanced imaging modalities available nowadays. Concerning the bilateral presentation of radix entomolaris it has been shown in many case reports that radix entomolaris can occur bilaterally in the same patient. Now it's time to know how to detect radix entomolaris on radiographs. We have three radiographic types of radix entomolaris. The first one is easily detected without the need to perform any beam angulation: this is type 1 of radix entomolaris. The type 2 radix entomolaris requires 15 to 25 degrees mesial beam angulation in order to be apparent on periapical radiographs. While type 3 requires at least 25 degrees of media beam angulation in order to be apparent since it is hidden exactly behind the main distal root. Now how does radix entomolaris appear in vivo or clinically or during our clinical work. Clinical inspection of the pulpal floor in a tooth with radix intermolaris show increased inter orifice distance distally than usual and here on the axial cut of a CBCT we can see the altered distance between the main distal component and the radix entomolaris.
cbct studies showed that radix entomolaris mostly curved in the buccolingual plane and this is very dangerous during instrumentation. It also possess abrupt curvatures and may be double curved. That's why a promo a proper mechanical pre-flaring is needed for efficient and problem-free shaping of this anatomical feature. Thank you for watching this POP lesson and see you soon in many more clinical lessons on POP Dentistry. Thank you