The conventional prowess termed hemisection: 2 case reports

Sumit Munjal

doi:10.21276/aohdr.1885

Abstract

Hemisection is a logical surgical option for treatment of a seemingly hopeless mandibular molar. Being a suitable alternative to extraction and implant therapy, it should be informed to each patient whenever indicated. The conservative demands have increased in dental practice and so have the pathological resorptions, root fractures and procedural accidents in endodontics. One case presented here was treated for furcation pathology and the other is reported with endodontic over instrumentation. A Perio- Prosthodontic management is demonstrated in both situations with an acceptable prognosis. For the reason that periodontal problems around resected molars have a tendency to recur, a sound diagnosis combined with a prudent case selection is a must. DOI:10.21276/AOHDR.1885

Highlights

The dental clinician often experiences a mandibular molar that seems to be hopeless or the prognosis is guarded. Regenerative procedures such as Guided tissue regeneration are unpredictable in severe bony defects in relation to molars
[1] In many situations, the resective option is justified to remove the affected part and save the tooth as a whole. This treatment modality i.e. hemisection, refers to sectioning of a mandibular molar into two halves followed by removal of the diseased root and its coronal portion
Mesial split was done in the one case as it was the diseased half and the distal was salvaged in the other since it was a victim of endodontic mishap

Summary

Introduction

The dental clinician often experiences a mandibular molar that seems to be hopeless or the prognosis is guarded. [1] In many situations, the resective option is justified to remove the affected part and save the tooth as a whole This treatment modality i.e. hemisection, refers to sectioning of a mandibular molar into two halves followed by removal of the diseased root and its coronal portion. The procedural accident was patiently explained to her and two options offered; either to remove her tooth as a whole or to amputate the affected half She decided for the later and a consent was obtained. Fig. 1: case 1 (a) Preop view, (b.) Preop Xray, (c.) Splitting, (d.) Amputated portion, (e.) Resected root & crown, (f.) Abutment smoothened, (g.) RCT completed, (h.) 1 year post op Xray. Fig. 2: case 2- (a.) Preop Xray, (b.) Incision and splitting, (c.) Amputated portion , (d.) Resected root & crown, (e.) Postop Xray, (f.) Postop view

Discussion

Conclusion