Fortunately, most of our dental work is fairly straightforward. You have an exam and a cleaning, or a cavity gets filled, or a crown might be used to protect a fragile tooth. But sometimes, a more complex dental problem affects one of your molars. In this case, it could be the right time to call in an endodontist like the doctor—a dental professional skilled in saving at-risk teeth.

Endodontists have two or more years of specialized training in the diagnosis and treatment of the inner tooth and the tissue surrounding it. An endodontist has the knowledge and experience to treat complex molar issues, and modern endodontics provides a number of options to protect the health and appearance of your natural teeth even when they have suffered an injury.

The inside of each tooth contains the vital (living) pulp, which includes blood vessels, nerves, and connective tissue. Once the pulp has suffered injury or infection, a root canal is almost always necessary to save the tooth. The bone and connective tissue surrounding the tooth can also suffer trauma or infection.

In the case of serious molar trauma or infection that goes beyond root canal treatment, the doctor might be able to save part or even most of your tooth with endodontic surgery. Two of the surgical procedures which can save such a molar are hemisection and bicuspidization.

When might an endodontist consider hemisection or bicuspidization?

• A root canal is a common endodontic procedure in which the damaged pulp is removed, and the tooth is cleaned, shaped, and sealed. Sometimes, though, an infection persists. In this case, part of the tooth might be removed to save the remaining natural tooth.
• When a traumatic vertical fracture occurs, a tooth is split from top to bottom. Depending on the location of the fracture, part of the tooth may be saved with surgical intervention.
• Serious decay or injury can damage a limited area of the tooth, while leaving another part of the tooth intact. Surgery can save the healthy part of the tooth.
• When periodontitis (serious gum disease) attacks the bone around the roots, severe bone loss can take place between the roots or around a single root. Surgery might be necessary to repair the damage.

In each of these procedures, the goal of the doctor is to preserve as much of your molar as possible. How is this done?

• Hemisection

In a hemisection, the injured tooth is split into two parts, and the part of the crown and the root that cannot be restored are removed. The remaining healthy crown area and root will be cleaned and treated, and a temporary crown will be put in place to protect the tooth. A permanent crown will then be designed to custom-fit the tooth.

• Bicuspidization

In this procedure, the damaged tooth is separated into two parts, each with a crown section and a root. The divided portions are cleaned and shaped, and temporary crowns will protect each section. A custom crown or crowns will be needed to cover and protect each segment of the tooth.

Why should you consider a hemisection or a bicuspidization? These procedures are alternatives to tooth extraction, and allow the doctor to preserve as much of your natural tooth as possible. While an implant or a bridge is certainly an option, we always prefer saving your natural teeth. If your dental problem involves the inner tooth or the tissue around it, ask us about your treatment options when you visit our Battle Creek, Michigan office. It’s not only worth your while—it’s worth your smile!