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

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Nonsurgical root canal treatment of mandibular third molars is complicated by limited access and complex anatomy, including the presence of radix paramolaris.
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Cone-beam computed tomography (CBCT) is essential for diagnosing complex root canal anatomy, as conventional radiographs may obscure accessory roots.
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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.

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