Root Resective Procedures: A Case Series of Tooth Hemisection and Bicuspidization with Prosthetic Rehabilitation in the Era of Dental Implants

Background/Objective: Root resective procedures are well established tooth-preserving techniques indicated when pathology is located to one root of a multirooted tooth or in the furcation area. Although for the last years implant therapy has become a standard approach in many cases, the rising incidence of peri-implantitis has renewed interest in classical conservative treatment alternatives such as hemisection, root resection and bicuspidization. The aim of this study is to present clinical cases in which hemisection and bicuspidization was performed to maintain compromised molars in function and achieve long term outcomes. Treatment: Three patients with localized periodontal destruction, vertical root fracture, subgingival caries were treated with hemisection and bicuspidization respectively. An interdisciplinary approach was followed in each case which involved clinical and radiological assessment, endodontic treatment or retreatment when required, extraction of the affected root and prosthetic rehabilitation designed to adjust occlusal force distribution. Follow-up examinations included radiographic and clinical examination. Results: The patients were fully satisfied with the outcome of the treatment and stable function were noticed on the follow-up appointments. Recall radiographic examination confirmed favourable bone healing, absence of recurrent pathology and periodontal stability, the prosthetic restorations remained functional with no signs of fracture, caries or more bone loss among the years. Conclusions: Resective techniques require an interdisciplinary approach, namely careful case selection, endodontic treatment, precise surgical technique and appropriate prosthetic rehabilitation are essential to provide a predictable and long-term outcome. Within the limitations of this case series, resective techniques proved to be a reliable and predictable alternative to extraction and implant placement in proper clinical cases.