World Journal of Dentistry

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VOLUME 10 , ISSUE 6 ( November-December, 2019 ) > List of Articles

CASE REPORT

Preservation vs Extraction of Carious Multirooted Teeth

Resmije Ademi-Abdyli, Feriall Perjuci, Yll Abdyli, Teuta Bicaj

Keywords : Abutment, Decay, Fixed denture, Hemisection, Mandibular molar, Multirooted, Preservation

Citation Information : Ademi-Abdyli R, Perjuci F, Abdyli Y, Bicaj T. Preservation vs Extraction of Carious Multirooted Teeth. World J Dent 2019; 10 (6):466-469.

DOI: 10.5005/jp-journals-10015-1683

License: CC BY-NC 4.0

Published Online: 01-12-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Introduction: Hemisection refers to the surgical separation of multirooted teeth when the decay or resorption is restricted to one root, followed by removal of the affected root with preservation of the healthy root with its crown portion and its usage as abutment for subsequent prosthetic restoration. Aim: The aim of this case report was to raise awareness among dentists that preservation of tooth structure in the form of hemisection may be considered an alternative treatment modality in cases of multirooted teeth with extensive caries restricted to one of the roots. Case description: This describes the hemisection procedure of right mandibular second molar performed in a 35-year-old female referred for extraction. Intraoral examination and intraoral periapical (IOPA) radiography revealed extensive decay of tooth 47, restricted to the distal root, with satisfactory condition of the mesial root and its crown portion to be preserved by hemisection and used as abutment for a fixed prosthetic restoration. 6 weeks after the successful hemisection, a three-unit metal-porcelain fixed denture was performed, using the retained mesial root of mandibular second molar (47) and the mandibular second premolar (45) as abutments and replacing the missing mandibular first molar (46). Conclusion: Preservation of tooth structure by performing hemisection in carious multirooted teeth in cases when caries is restricted to one of the roots should be considered a valuable alternative treatment instead of extraction; therefore, it should be discussed with patients as one of the treatment options whenever suitable and possible to perform. Clinical significance: The rationale of hemisection in our case is that it enabled the preservation of tooth structure by supplying an abutment for construction of a three-unit fixed partial denture, thus providing the patient the opportunity to maintain occlusal function with reduced financial cost over dental implants.


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  1. Jain A, Bahuguna R, Agarwal V. Hemisection as an alternative treatment for resorbed multirooted tooth—a case report. Asian J Oral Health Allied Sci 2011;1(1):44–46.
  2. Mittal P, Prasad AB, Raisingai D, et al. hemisection: a savior for hopeless teeth. J Mahatma Gandhi Univ Med Sci Tech 2016;1(1):30–34. DOI: 10.5005/jp-journals-10057-0008.
  3. Rajesh H, Dharamasi A, Rajesh KS, et al. Root resection: apropos of 6 cases. Arch Med Health Sci 2014;2(2):209–213. DOI: 10.4103/2321-4848.144342.
  4. Kost WJ, Stakiw JE. Root amputation and hemisection. J Can Dent Assoc 1991;57(1):42–45.
  5. Parmar G, Vashi P. Hemisection: a case-report and review. Endodontology 2003;15:26–29.
  6. Kurtzman GM, Mahesh L, Qureshi I. Hemisection as an alternative treatment for the vertically fractured mandibular molar. J Pak Dent Assoc 2012;21(3):177–181.
  7. Naveen YG, Patel JR, Parikh P, et al. Alternatives for restoration of a hemisected mandibular molar. BMJ Case Rep 2014;2014:010275. DOI: 10.1136/bcr-2013-010275.
  8. Radke U, Kubde R, Paldiwal A. Hemisection: A window of hope for freezing tooth. Case Rep Dent 2012;2012:390874. DOI: 10.1155/2012/390874.
  9. Regan JD, Witherspoon DE, Foyle D. Surgical repair of root and tooth perforations. Endod Topics 2005;11(1):152–178. DOI: 10.1111/j.1601-1546.2005.00183.x.
  10. Shah S, Modi B, Desai K, et al. Hemisection—a conservative approach for a periodontally compromised tooth—a case report. J Adv Oral Res 2012;3(2):31–35. DOI: 10.1177/2229411220120205.
  11. Menezes R, da Silva Neto UX, Carneiro E, et al. MTA repair of a supracrestal perforation: a case report. J Endod 2005;31(3):212–214. DOI: 10.1097/01.don.0000137639.85637.67.
  12. Vikram M, Vivekananda Pai AR. Salvaging a tooth by hemisection. Health Renaiss 2012;10(3):251–253. DOI: 10.3126/hren.v10i3.7057.
  13. Akki S, Mahoorkar S. Tooth hemisection and restoration an alternative to extraction—a case report. Int J Dent Clin 2011;3(3):67–68.
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