Research Article

Hemisection: A Conservative Management

of Periodontally Involved Molar
Tooth in a Young Patient
Aditi Jain1, Vaibhav Motghare2
Abstract
Hemisection is sectioning of multi-rooted teeth with its crown portion, with the loss of periodontal
attachment and is performed to retain the original tooth structure and attain the fixed prosthodontic
prosthesis. We describe hemisection of a mandibular molar tooth followed by adequate restoration in
a young patient.

Keywords: Hemisection, Mandibular Molar, Prosthodontic Periodontal

Introduction
Advances in dentistry have provided an opportunity to maintain a functional dentition for lifetime.1 Loss of the posterior
teeth is eventful and undesirable often leading to teeth drifting, loss of masticatory function and loss of arch length,
which requires prevention and maintenance measures.2 The oral cavity has the potential to harbor at least 600 different
bacterial species, and in any given patient, more than 150 species may be present.3,4 These bacteria are responsible for
various dental health issues such as dental caries and periodontal problems. Management of periodontally involved molars
with extensive decay is challenging and is limited to dental extraction and replacement with implants.5 Nevertheless,
treatment strategy to retain such teeth involves periodontal, prosthodontic and endodontic assessment for appropriate
selection to allow for stronger survival.1 Hemisection is a conservative way of preserving tooth. The term “hemi section”
or “root amputation” are synonyms for “root sectioning” or “bisection” and is a treatment modality, which allows the
preservation of tooth structure, alveolar bone and cost savings over other treatment options.

SR. Lecturer, MDS, Department of Conservative Dentistry & Endodontics, 2SR. Lect, MDS, Department of Public Health Dentistry,
1

Maitri College of Dentistry and Research Center, Anjora(Durg)Chhattisgarh.

Correspondence: Ms. Aditi Jain, MDS, Department of Conservative Dentistry & Endodontics, Maitri College of Dentistry and
Research Center, Anjora(Durg)Chhattisgarh.

E-mail Id: aditijain300789@gmail.com

How to cite this article: Jain A, Motghare V. Hemisection: A Conservative Management of Periodontally Involved Molar
Tooth in a Young Patient. J Adv Res Dent Oral Health 2017; 2(1&2): 9-11.

ISSN: 2456-141X

© ADR Journals 2017. All Rights Reserved.

Jain A et al.
Case Report
Discussion
The hemisection is a useful alternative treatment to
extraction to save the multi-rooted teeth by endodontic
approach, which includes the root canal treatment of
the remaining roots and restoring them with suitable
restorative material to splinting it with the adjacent
tooth to decrease the risk of displacement, followed by
a fixed prosthodontic prosthesis to maintain the occlusal
balance.7 The literature on distal root resection is limited
as compared to mesial root in mandibular molars because
of its anatomical structure.7,8 Nevertheless, hemisection
is a viable option to be considered before the extraction
of molars,9 especially in the presence of conditions such
as severe vertical bone loss (one root of a multi-rooted
ISSN: 2456-141X
J. Adv. Res. Dent. Oral Health 2017; 2(1&2)
tooth), furcation destruction, unfavorable proximity of
roots of adjacent teeth, preventing adequate hygiene in
maintenance of proximal areas and severe root exposure
due to dehiscence. Endodontic/restorative conditions
which require hemisection are prosthetic failure of piers
or abutments within a splint, endodontic failures, vertical
fracture of one root, and non-restorable portion of a multi-
rooted tooth.10
Buhler observed 32% failure rate in hemisection cases
attributed to endodontic pathology and root fracture while
other authors (0–9%) have shown a greater success in
hemisection cases in the long-term studies.5,9,10 In the
present case, good prognosis was observed with proper
occlusion, absence of mobility and healthy periodontal
10
J. Adv. Res. Dent. Oral Health 2017; 2(1&2)
condition up to 6 months of follow-up. Concurring with
previous reports, hemisection is a valid treatment option
for the molar teeth in young children, which otherwise have
to be extracted due to extensive caries.8 Thus, conservative
management of extensive carious molar tooth in young
patients can not only preserve the tooth but also reduce
the financial burden, psychological trauma and occlusal
dysfunction.
Conclusion
Hemisection is an alternative, effective, and conservative
treatment modality over conventional procedure or
extraction of periodontally and endodontic affected teeth.
Conflict of Interest: None
References
1. Jain A, Bahuguna R, Agarwal V. Hemisection as an
alternative treatment for resorbed multirooted tooth
– A case report. Asian J Oral Health Allied Sci 2011;
1: 44-46.
2. Behl AB. Hemisection of a multirooted tooth – A case
report. Open Access Sci Rep 2012; 1:1-3.
3. Saini R, Saini S, Sharma S. Oral sex, oral health and
orogenital infections. J Glob Infect Dis 2010; 2: 57-62.
11
Jain A et al.
4. Saini R. Dental air force home dental cleaning system:
A revolutionary oral hygiene device to prevent systemic
diseases caused by periodontal infection. Int J Med Res
Health Sci 2013; 2: 431-38.
5. Radke U, Kubde R, Paldiwal A. Hemisection: A window
of hope for freezing tooth. Case Rep Dent 2012; 390874.
6. Shetty P, Meshramkar R, Lekha K et al. Hemisection – A
Window of hope for a perishing tooth. Int J Clin Dent
Sci 2011; 2: 4-7.
7. Saad MN, Moreno J, Crawford C. Hemisection as an
alternative treatment for decayed multirooted terminal
abutment: A case report. J Can Dent Assoc 2009; 75:
387-90.
8. Shafiq MK, Javaid A, Asaad S. Hemisection: An option to
treat apically fractured and dislodged part of a mesial
root of a molar. J Pak Dent Assoc 2011; 20: 183-86.
9. Shah S, Modi B, Desai K et al. Hemisection – A
conservative approach for a periodontally compromised
tooth – A case report. J Adv Oral Res 2012; 3: 31-35.
10. Weine FS, editor. Endodontic Therapy. 6th Edn. Root
Amputation. Osaka: Mosby-Year Book, Inc 2004; 606-
39.
Date of Submission: 2017-06-20
Date of Acceptance: 2017-07-05
ISSN: 2456-141X