Hemisection: A Different Approach From Extraction

Abstract

Hemisection is the sectioning of teeth with multiple roots, the removal of the damaged root and its associated crown piece, and the preservation of the healthy root (with crown). When periodontal, resorption, perforation, or caries damage is limited to one root and the other root is still largely healthy, this treatment option may be taken into account. The right case selection is the most important component in determining the long-term success in such cases. This case report details the hemisection of a mandibular molar with root caries, followed by appropriate restoration.

"Hemisection – A Conservative Management of Compromised Bilateral Mandibular First Molars: A Case Report"

“…A lot of factors influence the clinician's decision for selecting a case for hemisection. These can be classified into three categories [8]: a) Local considerations, such as tooth anatomy, mobility, crown-to-root ratio, degree of attachment loss, the interaction between the inter-and intra-arch teeth, and strategic dental value for retention or removal. b) Clinical aspects include a careful case selection process, diagnostic and treatment planning abilities, knowledge of available therapy alternatives, and clinical insight or service delivery expertise c)…”

“…However, restoration may make the periodontal situation worse if the occlusal surfaces have inadequate margins or physiologic form. Furthermore, if the occlusal contact is constructed improperly, a tooth may be more susceptible to occlusion-related harm, and eventually hemisection may fail [8].…”

Hemisection: A Boon for the Hopeless Tooth

“…Platelet-rich fibrin (PRF) was made with the patient's blood. This autologous PRF was placed in the extracted root socket to facilitate better healing [6]. Following this, suturing was done using a 3-0 Vicryl suture using a figure of 8 technique.…”