| Summary: | Nature has signified the importance of first permanent molar by giving it the first rank in eruption sequence of the permanent dentition. First permanent molar erupts at the age of 6-7 years and hence is also known as "6 years molar." The study of root and root canal anatomy of molars in children is important for a successful pediatric practice. Normally the permanent mandibular first molar has two roots, one mesial and one distal root. Rarely an additional third root is seen, which is found distolingually and is called as radix entomolaris (RE). This extra root is typically smaller than the distobuccal root and is usually curved, requiring special attention when root canal treatment is being considered for such a tooth. The most frequent cause of endodontic failure is a canal that is left untreated because a clinician fails to recognize it and subsequently leads to extraction of the fundamental 6 years molar. Hence, this paper reports an unusual case and clinical approach of RE in a mandibular 6 years molar.
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