What are Radix Entomolaris and Radix Paramolaris

Definition of Radix Entomolaris: The presence of an additional Distolingual root in mandibular molars is known as the Radix Entomolaris. the extra root is on the lingual side of the roots.

Definition of Radix Paramolaris: The presence of an additional Distobuccal root in mandibular molars is known as the Radix Entomolaris. The extra root is present on the buccal side of the roots.

Radix Entomolaris and Radix Paramolaris diagnosis

Radix Entomolaris

Mandibular molars have 2 roots namely Mesial root and a Distal root which will have 2 -3 root canals, but the presence of a third root in mandibular molars was reported by De Moor et al in 2004 and named this root as Radix Entomolaris.

Radix Entomolaris and Radix Paramolaris are supernumerary roots present in the mandibular molars.

Radix Entomolaris and radix Paramolaris

Etiology:

Causes of this supernumerary roots is still unclear but few proposals are made:

  • External factors leading to odontogenesis
  • Atavastic gene or polygenetic system is also responsible

How to Diagnose presence of Radix Entomolaris and Radix Paramolaris:

  1. Presence of Radix Entomolaris and Radix Paramolaris can be diagnosed by a thorough inspection of Preoperative radiograph of the tooth.
  2. In case of any suspicion to reveal Radix Entomolaris, a second radiograph should be taken from a more Mesial or Distal angle of “20 – 25 degrees”. The same applies for Radix Paramolaris which will give us a clearer picture of the presence of and additional supernumerary root.
Radix Entomolaris and Radix Paramolaris radiographis diagnosis

If proper diagnosis of Radix Entomolaris and Radix Paramolaris is not done it will lead to complications in Endodontic and Surgical techniques.

So with the help of the position of the root position whether it is on the buccal or lingual side we can conclude if it is paramolaris or entomolaris. As we have mentioned that in Entomolaris the extra root is on the lingual side and in the Paramolaris the extra root is on the  buccal side of the tooth.

Complications due to Radix Entomolaris and Radix Paramolaris:

  • Presence of Radix Entomolaris and Paramolaris is a hindrance to Endodontic treatment such a root canal treatment where normally the presence of 2 roots is suspected and this can be easily missed in radiographic examinations and access opening procedures.
  • It leads to missed root canal in RCT which is a potential reason for future periapical lesions.
  • During extraction the supernumerary roots break off due to lack of strength to hold on to the tooth and the presence of RE and RP can be ignored and the broken root left in the socket, which can lead to future lesions if the tooth was infected.

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