Restor Dent Endod.  2016 Nov;41(4):322-331. 10.5395/rde.2016.41.4.322.

Radix mesiolingualis and radix distolingualis: a case report of a tooth with an unusual morphology

• Nayak G
• Aeran H
• Singh I

• KMID: 2356010
• DOI: http://doi.org/10.5395/rde.2016.41.4.322

Abstract

Variation in the root and canal morphology of the maxillary first molars is quite common. The most common configuration is 3 roots and 3 or 4 canals. Nonetheless, other possibilities still exist. The presence of an additional palatal root is rather uncommon and has been reported to have an incidence of 0.06 - 1.6% in varying populations studied. Whenever two palatal roots exist, one of them is the normal palatal root, the other is a supernumerary structure which can be located either mesiolingually (radix mesiolingualis) or distolingually (radix distolingualis). This case report describes successful endodontic treatment of a maxillary first molar with radix mesiolingualis and radix distolingualis. Identification of this variation was done through clinical examination along with the aid of multiangled radiographs, and an accurate assessment of this morphology was made with the help of a cone-beam computed tomography imaging. In addition to the literature review, this article also discusses the epidemiology, classifications, morphometric features, guidelines for diagnosis, and endodontic management of a maxillary first molar with extra-palatal root.

Keyword

Accessory root; Maxillary first molar; Palatal root; Radix distolingualis; Radix mesiolingualis; Root canal treatment

MeSH Terms

Classification
Cone-Beam Computed Tomography
Diagnosis
Epidemiology
Incidence
Molar
Tooth*

Figure

• 

  Figure 1 (a) Palatal surface of tooth #16 showing three well-developed lobulated cusps; (b) Access opening showing four root canal orifices of tooth #16. MB, mesiobuccal; DB, distobuccal; RML, radix mesiolingualis; RDL, radix distolingualis.

• 

  Figure 2 (a) A preoperative radiograph of teeth #15 and 16 (white arrows showing the outlines of the palatal roots and black arrows showing the outlines of the buccal roots of tooth #16); (b) Working length radiographs of tooth #16; (c) Master cone radiograph of tooth #16; (d) Post-obturation radiograph of tooth #16. MB, mesiobuccal; DB, distobuccal; RML, radix mesiolingualis; RDL, radix distolingualis.

• 

  Figure 3 Axial section of cone-beam computed tomography (CBCT) scan images of tooth #16 (a - e). (a) Showing three cusps on the palatal surface formed of enamel overgrowth; (b) Showing floor of the pulp chamber; (c) Showing two buccal and two palatal roots at the cervical third; (d) At the middle; (e) At the apical third level (rounded area). (f) A 3 dimensional reconstruction image of the maxilla showing two buccal and two palatal roots (rounded area).

• 

  Figure 4 Cone-beam computed tomography (CBCT) scan images of tooth #16. (a) Transverse section scan image showing the angle of divergence between the two palatal roots; (b - e) Axial sections; (b) Showing the distance between the palatal root canal orifices; (c) The distance between the buccal root canal orifices; (d) The distopalatal angle; (e) Mesiopalatal angle.

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