JOVD 2005: Hemisection and partial retention of carnassial teeth in client-owned dogs. Reiter AM, Lewis JR, Rawlinson JE, Gracis M.

Question 1

Authors?

Answer 1

Reiter AM, Lewis JR, Rawlinson JE, Gracis M.

Question 2

What was done in the study and why?

Answer 2

10 teeth were hemisected and the gingival tissues approximated over the extraction site. The remaining acorn root segment was treated endodontically with VPT or RCT. This was done to determine if hemisectioning and endodontic treatment can be used to treat carnassial teeth that are endodontically or periodontally affected individually or adjacent to a fracture line

Question 3

What are some of the indications for partial resection of a tooth?

Answer 3

• Inoperable root or crown-root fracture
• root caries
• dehiscence, fenestration
• external root resorption involving one root
• impaired endodontic treatment of a particular root
• advanced periodontitis affecting only one root
• severe furcation involvement

Question 4

What is the difference between root resection and hemisection of a tooth?

Answer 4

• Root resection (also referred to as root amputation) is the removal of a root with maintenance of the entire crown.
• Hemisection is the splitting of a multi-rooted tooth into two separate portions.
• Trisection is the splitting of a multi-rooted tooth into 3 separated portions.

Question 5

What are the indications for partial tooth removal in a human?

Answer 5

1. Teeth of critical importance to the overall dental treatment plan (e.g.,serving as abutments of fixed or removable restorations);
2. have sufficient attachment remaining for function
3. have no more predictable or cost effective method of regenerative therapy.(e.g., advanced periodontitis, external root resorption, or vertical tooth fracture involving only one root)
4. can be maintained with good home oral hygiene

Question 6

Where a portion of a tooth is being removed due to severe furcation exposure what are the recommendations regarding which root to remove ?

Answer 6

remove the tooth portion that

1. eliminatesthe furcation exposure;
2. has the greatest amount of attachment loss;
3. eliminates periodontal problems of adjacent teeth;
4. has the greatest number of anatomic peculiarities;
5. least complicates future periodontal maintenance.

Question 7

What percentage of teeth treated with hemi\section and vital pulp therapy remain vital at 5 years

Answer 7

13%

Question 8

What is the success rate of tooth sectionning in human?

And what is the major cause of failure?

Answer 8

• 62 - 100 %
• failure of the endodontic and restorative components

Question 9

What additional treatment was performed on some teeth and why?

Answer 9

The clinical crown height of the retained tooth segments in some dogs of this study, in particular the retained distal crown-root segment of the mandibular first molar tooth of dog 4, should have been reduced to prevent progressive injury from occlusal forces