Hemisection as an Alternative Management for Mandibular First Molar With Bifurcation Lesion and Root Fracture: A Case Report

Abstract

Modern advances in dentistry have provided the opportunity for patients to maintain a functional dentition for lifetime. Hemisection is a conservative way of preserving tooth. This procedure is an endodontic treatment performed by removing of the one or more roots and existing crown structure to increase retention of the remaining teeth and to correct defected dental roots that are not possible to maintain. The purpose of this study was to report a case of hemisection management in teeth with bifurcation lesion. A 24-year-old female patient complained of pain and discomfort arising from the right mandibular first molar during mastication. 2 years ago, the patient underwent endodontic treatment. Based on the clinical examination, a deep cavity and failed restoration were found in tooth 46. Radiographic view showed a radiolucency on distal root, bifurcation and fracture line in mesio-cervical region. Endodontic retreatment was performed by cementing prefabricated fiber post on distal root canal and hemisection procedure was performed in the mesial root. The tooth was restored with splinted zirconia crown. Hemisection procedure and final restoration showed a good result. Hemisection was an alternative treatment in this case. Tooth can be preserved in economical way. Case selection is essential in performing sequences of procedure for the success of treatment.