📖 Endodontics

Hemisection is the sectioning of a diseased tooth (usually a mandibular molar) into two parts and removing the diseased root and its connected crown part.

Hemisection is also called as “root amputation” or “root sectioning”.

 Hemisection is usually suggested in Mandibular Molars which have undergone failed Root canal treatment cases where we can see Furcation involvement making it difficult to clean using traditional Root canal therapy.
 
 The other reason can be due to procedural Errors by the Dentist is treating infected teeth such as Perforations etc.

Indications:
Multirooted tooth – Vertical Bone loss involving one root only

Furcation involvement with bone loss / infection from Buccal to Lingual aspect

Root Exposure due to dehiscence

Root Resorption in one root of a multirooted tooth

Unfavorable proximity of roots of adjacent teeth, preventing patient from maintaining adequate hygiene.

Vertical fracture of the tooth (one root), in cases where the vertical fracture is restricted to only one root while the other root is not affected, hemisection is preferred to save the tooth.

Contraindications :
Complicated Root anatomy making it difficult to Section one root without damaging the adjacent root. Fusion of Roots, Curved Roots etc.

Retained Root having calcified or inoperable canals

Adjacent teeth are strong enough for fabricating a bridge

Common Canal Configurations:
There are many combinations of canals that are present in the roots  of human permanent dentition, most of these root canal systems in any one root can be categorized in six different types.  These six types are:

Type I : Single canal from pulp chamber to the apex.

Type II : Two separate canals leaving the chamber but merging short of the apex to form only one canal.

Type III : Two separate canals leaving the chamber and existing the root in separate apical foramina.

Type IV : One canal leaving the pulp chamber but dividing short of the apex into two separate canals with two separate apical foramina.

Type V : One canal that divides into two in the body of the root but returns to exist as one apical foramen.

Type VI : Two canals that merge in the body of the root but re-divide to exist into two apical foramina.

Root Canal Classes:

Another classification has been developed to describe the  completion of root canal formation and curvature.

Class I : Mature straight root canal.

Class II : Mature but complicated root canal having-severe curvature, S-shaped course, dilacerations or bayonet curve.

Class III : Immature root canal either tubular or blunder bass.