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Root canals may be left untreated, if the dentist fails to identify their presence, leading to endodontic failure, particularly in teeth with anatomical variation in the form of extra roots or canals. Permanent mandibular first molars usually have 2 roots placed mesially and distally and 3 root canals. However, radix entomolaris (RE), an anatomical variant of permanent mandibular first molar, is characterized by the presence of additional or extra distolingual root. The prevalence of radix entomolaris in permanent mandibular first molars differs significantly with race but found to be very low among the Indian population. This case report is about the radiographic identification and endodontic management of radix entomolaris in a mandibular right first molar.

Radix entomolaris, Anatomic variation, Permanent three-rooted mandibular first molars, Distolingual root