Surgical endodontics
Hemisection of Multirooted Tooth
3Hemisection : 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:
- Severe bone loss and periodontally destructed one root and part of crown.
- Broken instrument which is irretrievable.
- Unrepairable perforation.
- Non-negotiable calcification of one root.
- Severe caries, resorptive defects and vertical root fracture
Contraindications of hemisection:
- Fused roots in which root separation is not possible.
- Root canal treatment of remaining root is unable to perform.
- 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














