Quick Review #286 - #dental #dentist #dentistry #dentalstudent #dentalschool #teeth #cavity #wisdomteeth #extraction #oralsurgery #oralsurgeon #implant #implants #dentalimplant #dentalimplants

As an oral and maxillofacial surgeon, I’ve found that mastering tooth sectioning techniques is crucial, especially in complex cases like horizontally or mesioangular impacted wisdom teeth. Two techniques I rely on are hemisectioning and coronectomy sectioning, each with its own strategic advantage.

When I perform a hemisection (as described in Peterson’s Principles of Oral and Maxillofacial Surgery), I use a surgical handpiece to section the tooth through the crown and into the interradicular space—between the roots. By dividing the tooth into distinct crown-root components, I can elevate each piece more conservatively. This reduces the stress on surrounding bone structures. Elevators are used to carefully deliver each segment, minimizing trauma—something Peterson’s emphasizes as essential to post-op healing.

Alternatively, in select cases, coronectomy (also covered in Peterson’s) is my go-to. Here, I carefully remove the crown first, leaving the root fragments behind initially. This can be advantageous when removing the roots poses a risk to the inferior alveolar nerve. After the crown is extracted, I address the roots separately or allow them to remain if conditions are right—a nerve-sparing approach that Peterson’s outlines for high-risk cases.

These techniques highlight that every extraction must be tailored. Whether we’re splitting crowns or strategically leaving roots, patient safety and long-term outcomes guide every decision.

References:

1. “Peterson’s Principles of Oral and Maxillofacial Surgery” – A foundational text detailing surgical techniques, including hemisection and coronectomy.

2. “Contemporary Oral and Maxillofacial Surgery” by Hupp, Ellis, and Tucker – Widely respected, it thoroughly covers dentoalveolar procedures and surgical sectioning approaches.

3. “Atlas of Oral and Maxillofacial Surgery” by Fonseca – Known for its detailed visual aids and step-by-step guidance on extraction techniques.

4. ChatGPT. 2026

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