Mandibular first molar. I often see an extra root in the mandibular first molar in the Asian population. I noticed that the extra root tends to be at the distolingual and often has a buccal apical acute curve. When it is at the distolingual it is called Radix Entomolaris. If it is on the buccal aspect, then it is called Radix Paramolais.
Patient presented with pain at the # 19 area. Diagnosis was acute symptomatic apical periodontitis. Non-surgical retreatment was recommended and completed.
Radix Entomolaris. Note the usual PDL of the distal root. When encountering images of this type, be suspicious of unusual anatomy and either take a CBCT to verify if take a mesial or distal shift shot radiograph.