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.
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.
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:
- Presence of Radix Entomolaris and Radix Paramolaris can be diagnosed by a thorough inspection of Preoperative radiograph of the tooth.
- 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.
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.
grace says
I had four first molars extracted for orthodontic treatment. one (extremely strong healthy tooth) was found to have RE during extraction. My braces are now of but I still have extremely bad tmj on the side the RE tooth was extracted and bad face sinking too. Was the orthodontist negligent not to pick up my RE fromantic xrays prior to the traumatic extraction?
Dr. Poonam says
Sir,
. Pls. read the article again. Paramolaris is replaced by entomolaris in the above article.
Varun says
It is correct, where is it replaced can you point it out Dr. Poonam. Entomolaris have an extra root on the lingual side and Paramolaris on the Buccal side.
dr.kirti says
radix paramolaris is extra mesiobuccal root not distobuccal root…reference cohen pathways of pulp
Zachary Greene says
In 1997 I had to have all my teeth removed because just about all of my teeth had accessory roots (ie where 2 roots where there should be 1 and 3-4 roots where there should have been 2) I was in my mid thirty’s at the time. I have search to find out exactly what that is called.
Varun says
Glad this was helpful