Dental Decks Perio : Page 2 : Root Amputation

Root Amputation and Hemisection

• Root amputation is the separation of an individual root from the crown of the tooth, often involving maxillary first and second molars.
• Burs and diamond stones are used to sever the crown and root prior to extraction of the remaining root.
• After root amputation, the apical area of the crown and furcation region are recontoured to provide maximal access for oral hygiene.

Indications and Considerations

• Root amputations or hemisections often result in irreversible pulpal damage, requiring endodontic therapy.
• Endodontic treatment should ideally be performed first to ensure patient comfort.
• The decision to perform a root resection may be made prior to or after flap reflection and evaluation of periodontal status.
• Consultation with both an endodontist and periodontist is required to ensure both aspects of treatment can be performed.

Hemisection Technique

• Hemisection is the vertical sectioning of a tooth through the crown and root, often used in mandibular molars.
• The technique involves dividing the tooth through the furcation, with one-half potentially extracted due to advanced bone loss.
• The remaining half of the molar tooth can be restored as a premolar.

Pontic Design for Crown and Bridge

• Sanitary and ovate pontics have convex undersurfaces, making them easiest to clean.
• Ridge-lap and modified ridge-lap designs have concave surfaces, making them more difficult to access with dental floss.
• The ovate pontic is the ideal pontic form due to its ease of cleaning and aesthetics.
• The alveolar bone must be a minimum of 2 mm from the most apical portion of the pontic.