Hemisection with socket preservation using alloplastic bone graft and platelet-rich fibrin
Downloads
Background: The developments in endodontics have created opportunities for patients to maintain functional teeth for longer. Surgical endodontic treatment, such as hemisection, has become a more conservative treatment than complex treatments, such as removable or fixed partial dentures or implants. Purpose: The aim of this treatment is to preserve the remaining tooth structure through a hemisection procedure and socket preservation using an alloplastic bone graft and platelet-rich fibrin (PRF). Case: A female patient presented with mastication pain and a large carious tooth in the right mandibular first molar and wanted to save the tooth. Examination showed deep caries and perforation in the bifurcation area of the tooth with loss of the distal crown. However, the mesial root could be preserved, thus hemisection was proposed. Case management: A root canal treatment was performed on the mesial root, followed by separation of the mesial and distal roots, and, finally, distal root extraction. A mixture of PRF and bone graft was used for socket preservation. The tooth was restored with a splinted zirconia crown. Conclusion: Hemisection with socket preservation using alloplastic bone graft and PRF represents a more conservative treatment option for molar teeth with extensive caries. This approach exhibits a good long-term prognosis and enhances the bone healing process.
Downloads
Ongkowijoyo CW, Mooduto L, Dinari D, Avianti RS. Hemisection of a severely decayed mandibular molar: Case report. Conserv Dent J. 2020; 10(1): 23–6. doi: https://doi.org/10.20473/cdj.v10i1.2020.23-26
Mokbel N, Kassir A, Naaman N, Megarbane J-M. Root resection and hemisection revisited. Part I: A systematic review. Int J Periodontics Restorative Dent. 2019; 39(1): e11–31. doi: https://doi.org/10.11607/prd.3798
Megarbane J-M, Kassir A, Mokbel N, Naaman N. Root resection and hemisection revisited. Part II: A retrospective analysis of 195 treated patients with up to 40 years of follow-up. Int J Periodontics Restorative Dent. 2018; 38(6): 783–9. doi: https://doi.org/10.11607/prd.3797
Falakaloglu S, Adiguzel O, Oztekin F, Deger Y, Ozdemir G. Hemisection: Two case reports. Int Dent Res. 2016; 6(1): 16. doi: https://doi.org/10.5577/intdentres.2016.vol6.no1.4
Widiadnyani NKE. Hemisection of the first-molars mandibula: a case report. Bali Med J. 2020; 9(1): 291–6. doi: https://doi.org/10.15562/bmj.v9i1.1668
Faqiha FA, Carissa C, Nugraheni T, Mulyawati E. Hemisection with crown splinter in perforation mesial canal wall first molar mandible: a case report. Bali Med J. 2021; 10(3): 1220–4. doi: https://doi.org/10.15562/bmj.v10i3.2855
Paul MP, Amin S, Mayya A, Naik R. Platelet rich fibrin in regenerative endodontics: an update. Int J Appl Dent Sci. 2020; 6(2): 25–9. web: https://www.oraljournal.com/archives/2020.v6.i2.A.826/platelet-rich-fibrin-in-regenerative-endodontics-an-update
Gupta S, Tikku A, Verma P, Bharti R. Hemisection with platelet rich fibrin: A novel approach. Saudi Endod J. 2020; 10(1): 61. doi: https://doi.org/10.4103/sej.sej_19_19
Ateeq-ur-Rehman, Bader Munir. Hemisection as an alternative treatment for mandibular molars with separated instrument: a case report. J Univ Med Dent Coll. 2022; 13(3): 453–5. doi: https://doi.org/10.37723/jumdc.v13i3.719
American Association of Endodontists. Glossary of endodontic terms. 10th ed. American Association of Endodontists; 2020. p. 1–48. web: https://www.aae.org/specialty/clinical-resources/glossary-endodontic-terms/
Zubaidah N, Kunarti S, Febrianti NN, Nurdianto AR, Oktaria W, Luthfi M. The pattern of osteocyte in dental socket bone regenerative induced by hydroxyapatite bovine tooth graft. Bali Med J. 2022; 11(3): 1489–93. doi: https://doi.org/10.15562/bmj.v11i3.3844
Prabowo TSY, Kresnoadi U, Hidayati HE. Effective dose of propolis extract combined with bovine bone graft on the number of osteoblasts and osteoclasts in tooth extraction socket preservation. Dent J. 2020; 53(1): 40–4. doi: https://doi.org/10.20473/J.DJMKG.V53.I1.P40-44
Wang W, Yeung KWK. Bone grafts and biomaterials substitutes for bone defect repair: A review. Bioact Mater. 2017; 2(4): 224–47. doi: https://doi.org/10.1016/j.bioactmat.2017.05.007
Haugen HJ, Lyngstadaas SP, Rossi F, Perale G. Bone grafts: which is the ideal biomaterial? J Clin Periodontol. 2019; 46(S21): 92–102. doi: https://doi.org/10.1111/jcpe.13058
Zhao R, Yang R, Cooper PR, Khurshid Z, Shavandi A, Ratnayake J. Bone grafts and substitutes in dentistry: a review of current trends and developments. Molecules. 2021; 26(10): 3007. doi: https://doi.org/10.3390/molecules26103007
Pendharkar SS. Alloplastic bone grafts in maxillofacial surgery – An overview. J Dent Spec. 2024; 12(1): 3–6. doi: https://doi.org/10.18231/j.jds.2024.002
Azhar I, Ayulita D, Laksono H, Margaretha T. The efficiency of PRF, PTFE, and titanium mesh with collagen membranes for vertical alveolar bone addition in dental implant therapy: A narrative review. J Int Oral Heal. 2022; 14(6): 543. doi: https://doi.org/10.4103/jioh.jioh_7_22
Anantula K, Annareddy A. Platelet-rich fibrin (PRF) as an autologous biomaterial after an endodontic surgery: Case reports. J Dr NTR Univ Heal Sci. 2016; 5(1): 49. doi: https://doi.org/10.4103/2277-8632.178979
Sravanthi T, Basam R, Basam L, Govula S. Hemisection with socket preservation using Platelet Rich Fibrin [PRF] - A case report with one year follow up. J Dr NTR Univ Heal Sci. 2021; 10(1): 59. doi: https://doi.org/10.4103/JDRNTRUHS.JDRNTRUHS_115_20
Dewi AR, Susanto A, Rusyanti Y. The treatment of gingival recession with coronally advanced flap with platelet-rich fibrin. Dent J. 2019; 52(1): 8–12. doi: https://doi.org/10.20473/J.DJMKG.V52.I1.P8-12
Soni R, Priya A, Yadav H, Mishra N, Kumar L. Bone augmentation with sticky bone and platelet-rich fibrin by ridge-split technique and nasal floor engagement for immediate loading of dental implant after extracting impacted canine. Natl J Maxillofac Surg. 2019; 10(1): 98. doi: https://doi.org/10.4103/njms.NJMS_37_18
Kökdere N, Baykul T, Findik Y. The use of platelet-rich fibrin (PRF) and PRF-mixed particulated autogenous bone graft in the treatment of bone defects: An experimental and histomorphometrical study. Dent Res J (Isfahan). 2015; 12(5): 418. doi: https://doi.org/10.4103/1735-3327.166188
Singh NR, Govind S, Kumari S. Management of mandibular molar having sub-gingival caries by root amputation: a case report. Indian J Forensic Med Toxicol. 2020; 14(4): 8874–7. doi: https://doi.org/10.37506/ijfmt.v14i4.13113
Kurdi A, Hidayati HE. Posterior maxillary prosthetic treatment with molar hemisection – a case report. Indones J Dent Med. 2018; 1(1): 22–6. doi: https://doi.org/10.20473/ijdm.v1i1.2018.22-26
Karimah F, Hutami ER, Nugraheni T, Mulyawati E. Hemisection as an alternative management for mandibular first molar with bifurcation lesion and root fracture: a case report. In: 4th International Conference on Sustainable Innovation 2020–Health Science and Nursing (ICoSIHSN 2020). Atlantis Press; 2021. doi: https://doi.org/10.2991/ahsr.k.210115.044
Ban S. Classification and properties of dental zirconia as implant fixtures and superstructures. Materials (Basel). 2021; 14(17): 4879. doi: https://doi.org/10.3390/ma14174879
Arora A, Arya A, Singhal R, Khatana R. Hemisection: A conservative approach. Indian J Dent Sci. 2017; 9(3): 206. doi: https://doi.org/10.4103/IJDS.IJDS_7_17
Lawson NC, Janyavula S, Syklawer S, McLaren EA, Burgess JO. Wear of enamel opposing zirconia and lithium disilicate after adjustment, polishing and glazing. J Dent. 2014; 42(12): 1586–91. doi: https://doi.org/10.1016/j.jdent.2014.09.008
Taori P, Nikhade PP, Mahapatra J. Hemisection: A different approach from extraction. Cureus. 2022; 14(9): e29410. doi: https://doi.org/10.7759/cureus.29410
Sharma S, Sharma R, Ahad A, Gupta N, Mishra S. Hemisection as a conservative management of grossly carious permanent mandibular first molar. J Nat Sci Biol Med. 2018; 9(1): 97. doi: https://doi.org/10.4103/jnsbm.JNSBM_53_17
Copyright (c) 2025 Dental Journal
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
- Every manuscript submitted to must observe the policy and terms set by the Dental Journal (Majalah Kedokteran Gigi).
- Publication rights to manuscript content published by the Dental Journal (Majalah Kedokteran Gigi) is owned by the journal with the consent and approval of the author(s) concerned.
- Full texts of electronically published manuscripts can be accessed free of charge and used according to the license shown below.
- The Dental Journal (Majalah Kedokteran Gigi) is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License
