What is a hemisection?
A hemisection is the procedure of cutting a tooth that has two roots in half. This will create a front half and a back half. This procedure can be done by a periodontist, an experienced dentist, an endodontist, or an oral surgeon. Hemisection means division into two.
Since the upper molars have three roots, hemisections can not be performed on the upper molars. It is possible to divide the upper molar into three parts though. This is called a trisection. It is also possible to remove one or two roots. This process is called root resectioning.
What is the hemisection used for?
The hemisection is performed when decay or bone loss from periodontal disease has affected the area in between the two roots. This is called bifurcation. Hemisection procedures allow the dentist to reach the affected area and provide treatment. When the roots have been separated, your dentist will be able to evaluate whether each half of the root can be restored or not. In certain situations, crown lengthening of one or more parts of the tooth and roots may be the best option. Crown lengthening will involve removal of gum tissue, bone, or even both so that the tooth’s surface is exposed. In certain situations, if the decay is to extensive, one or both of the halves will be removed or resected.
Hemisection procedures are less common nowadays. In some instances, the guided tissue can be used to regrow bone in the bifurcation area although people nowadays opt for tooth extraction and dental implants instead. The best option will depend on the extent of the decay or bone loss that affected the tooth. The probability of successfully restoring the tooth will be a factor as well. You should have a good conversation with your dentist about your possible options.
How do you prepare for a hemisection?
Before going through a hemisection, a tooth should go through a root canal treatment first. Your dentist will look at x-rays, examine your teeth and pinpoint areas of decay, and check the extent of your periodontal disease. You are going to b given anaesthesia prior to the operation.
How is a hemisection done?
Your dentist will make a small incision in the gum so that the deeper tooth structures are exposed. When the tooth is exposed, the roots of the tooth will be separated. Your dentist will remove the decay and parts of the tooth so that it can be saved. One or both roots may be saved or discarded.
The area will be cleaned with sterile saline solutions and if necessary, the incisions will be stitched closed. The tooth will be covered with a temporary filling or crown which is going to be replaced later on with a permanent crown.
A hemisection will take about half an hour to an hour to finish and this will depend on the amount of decay and periodontal disease present. Other procedures may also be needed prior to the hemisection.
What are the follow-up procedures after the hemisection?
You are going to feel some discomfort and swelling for the first two days. You will also experience some light bleeding for the first two days. You should avoid chewing with your tooth until all the stitches are removed. Your dentist will give you prescription mouthwash so that your mouth is kept clean afterwards.
After a week or two, you will return to the dentist and have your stitches removed. Your dentist will also monitor whether your gums are healing properly or not. After a few more months, the tooth should be healed enough to place a crown. You may get one crown that will fir on both halves which will leave space between the roots and allow easy access for hygiene. The two halves of the teeth can also be restored as individual teeth with two separate crowns. The individual tooth roots may be used to support the bridges. For instance, if you have two adjacent teeth hemisected and the two middle halves removed then your dentist may be able to place a bridge that will support the two remaining halves.
What are the risks of a hemisection?
A tooth that has been hemisected will be harder to clean. It will also be weaker than the average tooth. It will be more susceptible to breakage and fracture. If the tooth has further problems then it may have to be extracted.
If you are worried about the level of pain, swelling, and bleeding in the days after the procedure then you should get in touch with your dentist.