Hemisection is the process of cutting a tooth with two roots in half, creating a front half and a back half. It often is done by a periodontist, but any experienced dentist, endodontist or oral surgeon can do the procedure. Hemisection literally means “dividing in two.”
Because upper molars have three roots, a hemisection cannot be done on an upper molar. However, your dentist could divide an upper molar into three parts (sometimes referred to as trisection), or could remove one or two roots (root resection).
What It’s Used For
A hemisection is done when decay or bone loss from periodontal disease extends into the area between the two roots, called the bifurcation. The procedure allows your dentist to reach the affected area and provide treatment. Once the roots have been separated, your dentist will evaluate each half of the tooth and its root separately and determine whether they can be restored with crowns. In some situations, this may require crown lengthening of one or both parts of the tooth and roots. Crown lengthening involves the removal of gum tissue, bone or both to exposure more of a tooth’s structure. In other situations, your dentist may decide that the decay or bone loss is too extensive to allow restoration of one of the halves and roots. In this case, the severely affected half will be removed (resected).
Hemisection is less common than it used to be. In certain instances, guided tissue regeneration can be used to regrow bone in the bifurcation area. In many cases, people choose to have the tooth removed and replaced with an implant. The best option depends on the amount of decay or bone loss affecting the tooth and the probability that it can be successfully restored. You should talk with your dentist about your options.