The radix entomolaris (RE) is difficult to treat because the distolingual root is remarkably thin and extremely curved. In general, dental X-ray examinations tend to be insufficient due to confirm the complex root canal morphology. However, the cone-beam computed tomography (CBCT) can strongly support clinicians who want to treat these complex unusual cases, as it allows for accurate detection of root and root canal morphologies in three dimensions. In a recent case, we performed the root canal treatment on the mandibular left first molar using the dental operative microscope. Prior to the procedure, we detected three roots /five root canals, including the RE, and the second distobuccal root canal (DB2) through pre-clinical examination utilizing CBCT. When clinicians encounter complex root canals including the RE or DB2, micro-endodontic treatments with proper diagnosis based on a pre-treatment planning, as well as an adequate cleaning and shaping protocols are crucial points that lead to success.
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