Question 1

What is the difference between root resection and hemisection?

Accepted Answer

Both procedures remove part of a multi-rooted tooth to save the rest. Root resection (also called root amputation) removes ONE root of a maxillary molar while leaving the crown intact above the remaining 1–2 roots. Hemisection is performed on a lower (mandibular) molar — the tooth is split in half through the furcation and the diseased half is removed, leaving the healthy half as essentially a single-rooted tooth that's restored with a crown.

Question 2

How successful is root resection or hemisection?

Accepted Answer

Reported survival ranges widely depending on patient selection. Bühler's 10-year evaluation found about 68% of resected teeth still in function at 10 years. Fugazzotto's practice-based study reported about 96% cumulative survival at up to 15 years for carefully selected resected molars — comparable to molar implants in the same study (about 97%). The honest range to quote a patient is: 60–95% at 10 years, with the high end requiring strict candidacy.

Question 3

Is root resection or hemisection a good alternative to an implant?

Accepted Answer

Sometimes, yes — and increasingly, no. In the right patient (isolated single-root pathology, good remaining bone, no bruxism, excellent hygiene), Fugazzotto 2001 showed resection survival matches implant survival. In the wrong patient (generalized periodontitis, bruxism, poor hygiene, fused roots), an implant is more predictable. This is a shared decision that requires CBCT imaging, periodontal evaluation, and an honest conversation about long-term prognosis.

Question 4

Does the tooth need a root canal before resection?

Accepted Answer

Yes. The retained root(s) must have a successful root canal — ideally completed and verified BEFORE the sectioning, so we know the endodontic prognosis is good before we commit to the surgical step. Resecting a tooth whose remaining root then fails endodontically is the worst-case outcome and is preventable.

Question 5

How long does the procedure take and what's the recovery like?

Accepted Answer

The surgical sectioning itself is typically 60–90 minutes under local anesthesia. Most patients return to normal activity the next day. Sutures come out at one week. A temporary or interim restoration protects the tooth for 4–8 weeks while the soft tissue heals, then your general dentist places the definitive crown. Some discomfort and minor swelling for 2–3 days is normal and is managed with ibuprofen.

Question 6

Will my insurance cover root resection or hemisection?

Accepted Answer

Most PPO dental plans cover the procedure under CDT codes D3450 (root amputation) or D3920 (hemisection) when accompanied by a narrative and CBCT documentation showing single-root pathology. Coverage levels vary by plan (typically 50–80% of the specialist fee). Our office files pre-authorization on request and provides a clear written estimate before treatment.

Question 7

What if the resection fails — can I still get an implant later?

Accepted Answer

Yes, in most cases. When a resected tooth eventually fails, the remaining bone is usually sufficient for an implant — sometimes after a short healing period or a small graft. Saving the tooth first does not burn the implant bridge.

Root Resection & Hemisection — Patient Guide · Sunnyvale Endodontist