Have you been told you need a tooth extraction but want to preserve part of your natural tooth? A tooth hemisection might be a solution. This lesser-known dental procedure can save a damaged tooth by removing only part of it.
In this detailed guide, you’ll learn:
- What hemisection is
- When it’s recommended
- Step-by-step procedure
- Benefits, risks, recovery
- Comparison with similar treatments
- FAQs and case study
What Is Hemisection?
Hemisection is a dental surgical procedure where a multi-rooted tooth (usually a lower molar) is split into two halves, and one root along with the associated crown portion is removed, while the remaining half is retained and restored.
Hemisection helps avoid complete extraction by preserving a portion of the tooth that is still healthy.
Commonly Treated Teeth:
- Lower molars (mandibular first and second molars)
- Occasionally, upper molars
Indications: When Is Hemisection Recommended?
Hemisection may be the treatment of choice in situations such as:
| Condition | Reason for Hemisection |
|---|---|
| Vertical root fracture in one root | To remove fractured root and preserve the rest |
| Severe bone loss on one side of the tooth | To retain the healthy root with good support |
| Failed root canal on one root | To extract the affected root and restore the rest |
| Caries affecting only one root | Allows conservative removal of diseased area |
| Preparation for fixed prosthesis (bridgework) | To retain one root as an abutment |
How Is Hemisection Performed?
Step-by-Step Procedure:
- Diagnosis & Imaging
- X-rays or CBCT scans are taken to assess bone and root conditions.
- Anesthesia
- Local anesthesia is administered to numb the area.
- Access and Sectioning
- The crown is split using a dental bur to expose the roots.
- Removal of Diseased Root
- The root that is infected, fractured, or damaged is extracted.
- Smoothing and Irrigation
- The socket is cleaned and shaped to promote healing.
- Restoration
- The remaining tooth is restored with a crown or bridge.
Benefits of Hemisection
- Tooth Preservation: Retains part of the natural tooth
- Cost-effective: Less expensive than implants
- Improves Prosthetic Stability: Can support bridges
- Minimally Invasive: Compared to full extraction and implant placement
Risks and Complications
Although generally successful, hemisection may carry potential risks:
- Root fracture of remaining portion
- Infection or failure of the retained root
- Bite imbalance or occlusal stress
- Need for extraction later if it fails
Proper case selection and post-op care reduce risks.
Post-Treatment Recovery and Care
| Timeline | Recovery Milestone |
|---|---|
| Day 1–3 | Minor bleeding, swelling, tenderness |
| 1 week | Sutures (if any) removed, discomfort subsides |
| 2–3 weeks | Soft tissue healing completes |
| 1–2 months | Final crown or bridge placement |
Care Tips:
- Maintain excellent oral hygiene
- Avoid hard foods until fully healed
- Use prescribed antibiotics or mouthwash
- Attend regular dental check-ups
Comparison: Hemisection vs Similar Procedures
| Procedure | What Happens | Tooth Preservation | Cost | Healing Time |
|---|---|---|---|---|
| Hemisection | Removes 1 root, keeps the rest | ✅ Yes | $$ | 2–4 weeks |
| Extraction | Entire tooth removed | ❌ No | $ | 1–2 weeks |
| Implant | Replaces extracted tooth with a screw | ✅ Replacement only | $$$$ | 3–6 months |
| Root Resection | Removes only a root tip (not crown) | ✅ Yes | $$$ | 2–4 weeks |
Case Study: Saving a Molar with Hemisection
Patient: Rajesh, 42, non-smoker, good oral hygiene
Problem: Severe bone loss and decay on the distal root of lower first molar
Treatment: Hemisection with removal of distal root, followed by crown on mesial portion
Outcome: Tooth retained for over 6 years with excellent function and hygiene
Frequently Asked Questions (FAQ)
1. Is hemisection painful?
No. It’s performed under anesthesia. Mild discomfort after surgery can be managed with painkillers.
2. How long does a hemisected tooth last?
With proper care, hemisected teeth can last 5–10 years or more.
3. Is root canal required before hemisection?
Usually yes. A root canal is performed on the part of the tooth to be retained.
4. Can I chew normally after hemisection?
Yes, once healing is complete and the restoration is placed.
5. What’s the success rate?
Studies show success rates between 70–90% depending on case selection.
Final Thoughts
Hemisection is a tooth-saving procedure that offers a practical alternative to full extraction and implant placement. When performed on the right candidate, it can preserve function, aesthetics, and patient comfort.
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