CONSERVATIVE MANAGEMENT OF A GROSSLY DECAYED MANDIBULAR MOLAR WITH RADIX ENTOMOLARIS: ENDODONTIC THERAPY AND POST-ENDODONTIC REHABILITATION

The management of grossly decayed teeth with compromised periodontal support and anatomical variations presents a significant clinical challenge in endodontics. Radix entomolaris, characterized by an additional distolingual root,further complicates diagnosis and treatment due to its complex morphology.This case report describes the conservative management of a 27-year-old female patient presenting with a grossly decayed mandibular molar in the lower right posterior region. Clinical examination revealed extensive coronal destruction without tenderness or mobility, while radiographic findings showed periodontal bone loss, furcation involvement, and an additional distolingual root suggestive of radix entomolaris. A diagnosis of pulpal necrosis with asymptomatic apical periodontitis was established.Nonsurgical root canal treatment was performed with careful identification and management of the additional canal, followed by chemomechanical preparation and intracanal medicament placement. Obturation was completed using gutta-percha and a bioceramic sealer to achieve a three-dimensional seal. Post endodontic rehabilitation including placement of a prefabricated metal post, core build-up, and full-coverage crown. The patient was also referred for periodontal management.This case highlights the importance of accurate diagnosis, awareness of anatomical variations, and a multidisciplinary approach in managing complex endodontic cases. It demonstrates that teeth with a questionable prognosis can be successfully preserved with meticulous treatment planning and execution.