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Q. Is it advisable to get hemisection done in a molar with crown and abscess?

Answered by
Dr. Naveen Thomas
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on Dec 27, 2019

Hello doctor,

My crown has become loose as there is decay inside the crown and around half the edge but not visible. I was told that tooth is stable underneath. I saw one endodontist who said to rule out implant and he would do root canal but bone and gum are less than ideal and 50-50 chances are there that it will work. He also did not clear all the decay, did not take the crown off but drills straight through. (A wobbly decayed tooth underneath crown?), did not do the post or crown. There is a long standing chronic abcess at root for years. Current root canal was done 7 years ago. I do not have any other molars left in lower. I am in shocked, sad, anxious and 60 years old.

I feel tempted to go to an unknown dentist just to see if he could do a hemisection as the Endodontist I talk to "no longer do them as implants are available and hemis tend not to last long". Does anyone reading this please see any hope for this tooth? I chew on it and have no sensitivity and no pain; no symptoms at all. There is gum recession I have complained to dentist about for the last couple of years. I am concerned I will regret not trying to save this tooth if at all possible. Also told to see prosthodontist to ensure a crown could be made if I get the retreatment. I have two tracks I am pursuing. I will see an oral surgeon tomorrow to rule out implant and then see prosthodontist. I am attaching X-rays. Concerned in this decision making process about any further damage being done to gum and or bone. Impeccable hygiene history.

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Hello,

Welcome to icliniq.com.

Seeing the recent X-rays (attachment removed to protect patient identity) it is obvious that the distal root has abscess and should be removed. Hemisection might be a good idea but it alone cannot withstand the biting force and if you can afford, then go for a molar implant behind this tooth so that you will get one extra molar to chew on. A hemisection to retain the mesial root of this tooth along with another implant behind it will give adequate tooth structure to have a normal biting force. If you cannot afford both then go for extraction of this abscessed tooth and an implant as hemisection alone is not strong unless it has more support behind it.


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