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Management of a Mandibular Third Molar With Radix Paramolaris: A Case Report

  • By

  • Zak R. James, DMD

  • September 1, 2026

  • 11 min

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  • 1

    Nonsurgical root canal treatment of mandibular third molars is complicated by limited access and complex anatomy, including the presence of radix paramolaris.

  • 2

    Cone-beam computed tomography (CBCT) is essential for diagnosing complex root canal anatomy, as conventional radiographs may obscure accessory roots.

  • 3

    An 86-year-old patient with pulpal necrosis and symptomatic apical periodontitis was treated conservatively through an existing crown.

  • 4

    Heat-treated nickel-titanium rotary instruments facilitate effective canal negotiation in challenging cases while preserving tooth structure.

  • 5

    The case highlights the importance of recognizing unusual anatomy, such as radix paramolaris, to inform treatment planning and avoid complications.

Original Source(s)

Management of a Mandibular Third Molar With Radix Paramolaris: A Case Report

  • by Zak R. James, DMD

  • September 1, 2026

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