Paramolar tubercle in endodontics: An overview, case report and specimen study

Paramolar tubercle is an additional cusp occurring on the buccal surface of a permanent maxillary molar. Due to their overall low occurrence, there is limited information about root anatomy of paramolar tubercles. Periapical radiographs do not always image the root canal associated with the paramolar tubercle. Teeth with paramolar tubercle can promote problems like dental caries, gingivitis, periodontitis, and may pose problems to the clinician in procedures like orthodontic banding and rubber dam placement. Although, small paramolar tubercles may not have pulp tissue, a very large tubercle may contain separate pulp chamber and associated root canal. For successful management of such teeth requiring endodontic or periodontal therapy, advanced radiographic diagnostic aids should be used. In this paper this anatomical variation in maxillary second molar, was studied (i) by clinical examination, radiographic examination using intra-oral radiography and (ii) macroscopic examination, radiographic examination and by clearing technique in vitro.