Mandibular molars can have an additional root located lingually (the radix entomolaris) or buccally (the radix paramolaris). If present, an awareness and understanding of this unusual root and its root canal morphology can contribute to the successful outcome of root canal treatment. This paper describes case report of mandibular first molar with three roots (one mesial and two distal) and four canals (two in mesial and two in distal root). These case reports show an anatomic variation of internal morphology of the tooth and points out the importance of searching for additional canals.
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