Hemisection of the first-molars mandibula: A case report

Background: Hemisection is an endodontic surgery performed by removing one or more roots and existing crown structures to increase retention of the remaining teeth and to correct defected dental roots that are not possible to maintain. This study aims to evaluate the treatment of hemisection in the lower left first molar in the mesial tooth root with the restoration of the splint crown end with tooth 35 as retention at Sanglah General Hospital, Bali, Indonesia. Case Description: Male patient aged 21 years, in tooth 36 there is a cavity with a temporary restoration accompanied by a periodontal abscess. Teeth are sensitive to percussion tests and palpation, mobility is normal. Radiographic features appear to be perforated in the furcation section, and furcation involvement. Diagnosis of teeth 36 pulp necrosis is accompanied by abscess periodontal. During the first visit periodontal abscess drainage was performed, followed by functional crown lengthening in the periodontia. After one week of observation, there were no complaints, continued treatment of the distal root canal until the root canal filling. The next visit was carried out hemisection surgery in the form of separation of root bifurcation and extraction of mesial roots to the existing crown structure. Two months after the surgical procedure was evaluated, there was a good increase in bone density and no complaints. Then, the tapered serrated post was accompanied by the manufacture of composite core and final restoration using PFM crown splint with tooth 35 as retention. Conclusion: Surgical treatment of hemisection is a reliable alternative solution and has a good prognosis because it can maintain dental and periodontal tissue as long as possible without tooth extraction.