| Summary: | Mandibular first molar and primary molars usually have two roots, on the mesial and distal sides. Occasionally, these molars have an extra root located in the distolingual aspect. Prevalence of the 3-rooted first permanent molar shows ethnic variation, ranging from about 3% in Caucasian to about 20% in Mongoloid group, which includes Chinese, Japanese, Eskimo, American and Canadian Indians. The frequency of the mandibular molar with three roots decreases in the order of the first permanent molar, the second primary molar, and the first primary molar. If the mandibular first or second primary molar has an additional distolingual root, the adjacent molars, including the first permanent molar, posterior to it also may have it. Coronal morphologic change can occur in the mandibular first primary molars with three roots: the crown had more triangular-shape compared to the one with two roots, possibly affected by the presence of additional distolingual root. Clinically, exact diagnosis and treatment should be taken with those teeth for pulp canal treatment, extraction, and SS Cr open
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