The aim of this study was to evaluate the radix entomolaris (RE) and middle mesial canal (MMC) in mandibular permanent first molars in an Iraqi subpopulation using cone-beam computed tomography (CBCT). Their prevalence and types were investigated in 201 patients (301 tooth subjects), among which 156 were of the right side, and 145 of the left side mandibular first molars (MFM), using CBCT scans. The effects of gender, age, and unilateral/bilateral on the presence of both RE and MMC were evaluated. Chi-square and Fisher's exact tests were used to determine the level of significance ( p ≤ 0.05), and the kappa value was used to check reliability of results of the research. In MFM, the prevalence of right and left RE was 4.5% and 4.1%, respectively, and it was significantly higher in males than females ( p = 0.006) based on the Chi-square test. No significant difference was identified in the prevalence of RE in relation to age and tooth position. MMC was found in 14.7% of teeth in the right side and 19.3% in the left side, with no significant differences for age or gender. MMC merged with mesiolingual canal presented with higher prevalence compared to other types of MMC (8.3% right side and 7.6% left side), again with no significant differences for age or gender. Within the limits of this study, no significant association was detected between the prevalence of MMC and RE in MFM.
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