Hemisection in the dental implants era – why do we still consider this option?
Dr. Krzysztof Gronkiewicz1, Dr. Paweł Szczurowski2
1 Department of Prosthodontics and Orthodontics, Institute of Dentistry, Faculty of Medicine, Jagiellonian University, Krakow, Poland,
2 Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College
Introduction: In the age of dental implants, the question of whether to save or extract natural teeth remains a critical consideration in dental practice. Despite the advancements in implant technology, the preservation of natural dentition continues to be a primary goal in modern dentistry. This discussion explores the rationale behind prioritizing the conservation of natural teeth over extraction and replacement with dental implants.
Case Report: Patient with the lower compromised multirooted molar came to the office to restore it. The goal of the patient was to save the tooth, and she refused to install the implant. The one part of the tooth was removed and the second was restored utilizing post, core and crown. Restoration was splinted with the neighboring tooth which also required reconstruction.
Discussion: The decision to save a natural tooth involves a comprehensive evaluation of various clinical, functional, and patient-specific factors. From a functional standpoint, natural teeth offer superior proprioception and chewing efficiency compared to dental implants, contributing to overall oral health and well-being. Furthermore, preserving natural teeth helps maintain the integrity of the surrounding bone and soft tissues, preventing bone resorption and preserving facial aesthetics.
Additionally, saving natural teeth can be more cost-effective for patients in the long term, as it avoids the initial expense of implant surgery and the potential for future complications or replacement. From a psychological perspective, retaining natural teeth preserves the patient's sense of identity and emotional attachment, which may be compromised by tooth loss and replacement with implants.
Furthermore, advancements in endodontic techniques and materials have significantly improved the success rates of root canal treatments, making them a viable alternative to extraction.
Through a comprehensive assessment of clinical, functional, and patient-related factors, dentists can determine the most appropriate course of action to optimize oral health outcomes and patient satisfaction.