Vol. 11, Issue 4, Part D (2025)

Anatomical variations in mandibular molars present a significant challenge in endodontic therapy. One such rare variation is the radix paramolaris, an additional supernumerary root located buccally. Failure to identify and treat this anomaly may lead to persistent pathology and compromised prognosis. This case report describes the diagnosis and successful endodontic management of a mandibular molar with radix paramolaris. Careful radiographic examination and clinical exploration were crucial for identifying the additional root. Access cavity design was caries driven which facilitated canal location, followed by cleaning and shaping using a rotary NiTi system and irrigation protocol to ensure disinfection. Obturation was completed with a warm vertical compaction technique, achieving a three-dimensional seal. The patient remained asymptomatic with satisfactory periapical healing at follow-up. This report underscores the importance of awareness, accurate diagnosis, and the use of advanced techniques in managing rare root canal anatomical variations.