Radix entomolaris: treatment and follow-up

Patient was referred by the orthodontist for evaluation and treatment of tooth 4.6 seeing as he was about to start his orthodontic treatment. Clinically, tooth 4.6 presented a class 1 restoration with no signs of leakage, fairly close to the pulp chamber. Sensibility cold test was -, percussion tested ++, palpation showed no signifiant response. Patient had solely a preop panoramic x-ray on which a radiolucency was confirmed on all roots and based on which I suspected the presence of a supranumerary root. For a proper assessement of diagnosis and treatment plan, a small FOV CBCT was taken. Diagnosis was established based on everything as pulp necrosis, localized symptomatic apical periodontitis and a radix entomolaris aspect with a DL supranumerary…