A 3‐year study of hemisectioned molars

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Abstract
Over a period of 1-7 (average 2.9) yr, 34 hemisectioned molars were examined clinically and radiographically. All patients were kept on a 3-6 mo. recall system. The indications for hemisectioning were periodontal in 9 cases and endodontic in 20 cases. In 4 cases extensive carious destruction and in 1 case an external granuloma led to hemisectioning. Mainly mandibular molars were treated (27). Root resectioning was carried out on only 7 maxillary molars. Twenty-two of the treated teeth were used as distal abutments for small fixed bridges. For a further 3 the same was planned. The remaining treated teeth were singly crowned. Of the 34 treated molars, 7 were considered failures, 6 for endodontic reasons (apical periodontitis) and only 1 for periodontal reasons. No correlation between failure and the length of the follow-up period was found. With 17 of the 34 molars a significant reduction in periodontal pocket depths was recorded between commencement of treatment and the final examination. No difference in periodontal pocket depth or in the height of the alveolar crest was found between hemisectioned and nonhemisectioned surfaces. The mobility of hemisectioned molars was difficult to judge because 22 of the 31 crowned teeth were used as abutments for bridges. Seventeen of the 22 bridges were firm, 4 showed mobility of 1.degree. [tooth mobility just palpable] and 1 showed mobility of II.degree. [tooth mobility visible]. Of the singly crowned teeth, only 1 exhibited mobility of III.degree. [tooth mobility on lip or tongue pressure and/or in an axial direction]. The prognosis for hemisectioned teeth is favorable. Failures were primarily endodontic in origin rather than periodontal. Periodontal damage can be kept to a minimum by regularly reviewing oral hygiene standards. Treated teeth may be used as abutments for small bridges if attention is paid to achieving optimal articulation.

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