Category Archives: Surgical endodontics

Hemisection of Multirooted Tooth

Hemisection : is the procedure in which multi-rooted tooth is surgically divided into two half through the bifurcation of tooth buccolingually.The diseased half of the crown and root will be removed and the other half will be retained which is sound

Indications of hemisection:

  1. Severe bone loss and periodontally destructed one root and part of crown.
  2. Broken instrument which is irretrievable.
  3. Unrepairable perforation.
  4. Non-negotiable calcification of one root.
  5. Severe caries, resorptive defects and vertical root fracture

Contraindications of hemisection:

  1. Fused roots in which root separation is not possible.
  2. Root canal treatment of remaining root is unable to perform.
  3. When bony support for remaining root is insufficient for restoration.

Case No 1

This is Radiograph of 27 year old female showing mesial proximal caries, bone loss and broken instrument in mesial root of mandibular 1st molar.

Radiograph showing obturation of distal root before hemisection.

Mesial root of Madibular 1st molar has been hemisectioned

Case no 2

Radiograph showing perforation of mesial root with in advert use of K-file. distal was alright so the tooth was planned for hemisection of mesial root.

Radiograph showing obturation of distal root before hemisection

Mandibular 1st molar before hemisection

Tooth was divided into two halves with fissure bur

Divided tooth

Extraction of mesial part of tooth

Curettage of extracted socket

Restoration of remaining part with IRM

Restoration of remaining part with IRM

Radiograph showing hemisectioned tooth

Distal view of extracted root showing perforation

Extracted root with files in perforation