What are the alternatives to hemisection dental surgery?

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Jonathan H. Ross, DDS
Periodontics

Hemisection is performed on mandibular molars. It was more common before the development of titanium endosteal implants. The alternatives for hemisectioning a tooth depend on the reason for the need to section the tooth and the condition of the neighboring teeth. I will go over some, but not all, of the factors that go into treatment planning.

  • If the mandibular molar to be hemisectioned has lost bone between the roots but otherwise has good bony support, regenerative surgery could be performed to gain new bone between the roots. If there is also some loss of support on other sides of that tooth, the space between the roots can be tunneled out to allow for easier access for oral hygiene tools.
  • If the bone loss is severe around the entire tooth or it is mobile, hemisectioning a tooth is not recommended. Depending on the condition of the neighboring teeth, the tooth may be extracted and a bridge, implant, or partial denture could replace the tooth.
  • A hemisected tooth will need root canal therapy and will be splinted to another tooth via a 2-unit or greater bridge.
  • If the molar has little healthy tooth structure above the gum line, hard and soft tissue will have to be removed to allow the dentist to place a crown on that root/tooth. If too little of the remaining root will be in bone compared to the tooth above the gum line, the tooth should be extracted.
Hemisection dental surgery entails cutting the tooth in half to save part of the tooth. The alternatives to hemisection dental surgery are to remove the entire tooth and put in a permanent implant or removable dental bridge--or to do nothing.

If you decide to do nothing, you run the risk of losing the tooth to disease. One study followed patients with periodontal (gum) disease beneath the tooth for 15 to 34 years. These patients only had maintenance and conservative treatment, not surgery. In this study, 44% of the patients lost the tooth during that time.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.