Hemisection

Hemisection is a conservative surgical procedure used to save a tooth that has a healthy root and crown structure on one side but is diseased or damaged on the other. It involves the removal of one root and its corresponding part of the crown in a multi-rooted tooth—typically a lower molar—while preserving the rest of the tooth.

This procedure is an excellent alternative to full tooth extraction when part of the tooth remains healthy and can still function effectively after treatment.

Why It’s Done

Hemisection is performed when one root of a tooth is severely compromised due to:

Advanced periodontal disease affecting one root
Vertical root fracture
Extensive decay or infection in one root
Failed root canal in one root, with the other root remaining healthy

Rather than extracting the entire tooth, hemisection allows for the preservation of part of it, supporting overall dental structure and function.

When Is Hemisection Considered?

Molars with two roots (usually mandibular molars)
One root shows severe decay, bone loss, or fracture
Remaining root and structure are strong and disease-free
Tooth is in a strategic location and important for chewing function
Patient prefers tooth preservation over extraction and implant

What the Procedure Involves

Clinical & Radiographic Evaluation: A thorough examination and X-ray are done to assess root condition, surrounding bone, and the potential for restoration.
Endodontic Treatment: A root canal is performed on the retainable root (if not already done), and the diseased root is identified for removal.
Surgical Hemisection: Under local anesthesia, the gum is opened, the crown is sectioned, and the diseased root along with its part of the crown is carefully removed.
Cleaning & Debridement: The area is cleaned, and any infected tissue or granulation is removed.
Restorative Phase: The remaining portion of the tooth is reshaped and usually restored with a crown or bridge to ensure strength and function.

Post-Treatment Care

Pain, swelling, or mild discomfort may occur for a few days
Antibiotics and painkillers may be prescribed
Soft diet for the first 24–48 hours
Maintain excellent oral hygiene to prevent reinfection
Follow-up visits to monitor healing and restoration

Ideal For

Patients with partially diseased molars
Those preferring a conservative alternative to extraction
Individuals with good overall oral hygiene and bone support
Patients not ready for dental implants

Benefits

Preserves part of a natural tooth that would otherwise be lost
Maintains jawbone and gum integrity
Offers a functional and cost-effective alternative to extraction and implants
Restores chewing efficiency and aesthetics
Avoids the need for prosthetics in many cases