Case 21 Hemisection to preserve tooth

Pre-operative x-ray


Patient presented with a periodontal pocket along side mesial root, with a diagnosis of fracture mesial root.  Options discussed; extraction of whole tooth or hemisection of mesial root.  Patient wanted to save as much tooth as possible.  An implant was not an option. I told patient, if the tooth was hemisected, not to restore the tooth until it was stable with no periodontal pockets.


Immediate post operative x-ray


Distal root is stable.






8 mo check appointment


Mesial root socket has healed. Patient is asymptomatic and distal root is firm.  Patient can either have a single unit crown or three unit bridge.





Comment:
Hemisections are an option when the patient has choices on treatments including implantation.  If a patient desires tooth retention, then this option of hemisection is a good choice. I do not think full coverage is necessary until the remaining root is stable and periodontally sound.