$$ \begin{aligned} \frac{x^2}{x^2}+9x+18 &= 0&& \text{multiply ALL terms by } \color{blue}{ x^2 }. \\[1 em]x^2\frac{x^2}{x^2}+x^2\cdot9x+x^2\cdot18 &= x^2\cdot0&& \text{cancel out the denominators} \\[1 em]x^2+9x^3+18x^2 &= 0&& \text{simplify left side} \\[1 em]9x^3+19x^2 &= 0&& \\[1 em] \end{aligned} $$
In order to solve $ \color{blue}{ 9x^{3}+19x^{2} = 0 } $, first we need to factor our $ x^2 $.
$$ 9x^{3}+19x^{2} = x^2 \left( 9x+19 \right) $$
$ x = 0 $ is a root of multiplicity $ 2 $.
The second root can be found by solving equation $ 9x+19 = 0$.
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