The nuts and bolts of hemisection treatment: Managing congenitally missing mandibular second premolars

When you treat the congenital absence of mandibular second premolars by extracting the residual deciduous second molar and closing the space, you run the risk of flattening facial fullness, especially in patients with nonextraction features—diminished facial fullness, absence of crowding, and reduce...

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Bibliographic Details
Published in:American journal of orthodontics and dentofacial orthopedics 2005-05, Vol.127 (5), p.606-610
Main Author: Northway, William M.
Format: Article
Language:English
Subjects:
Anodontia - surgery
Bicuspid - abnormalities
Bone Diseases, Metabolic - physiopathology
Dentistry
Humans
Mandible
Mesial Movement of Teeth
Molar - surgery
Orthodontic Space Closure
Tooth Crown - surgery
Tooth Extraction
Tooth, Deciduous - surgery
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Summary:When you treat the congenital absence of mandibular second premolars by extracting the residual deciduous second molar and closing the space, you run the risk of flattening facial fullness, especially in patients with nonextraction features—diminished facial fullness, absence of crowding, and reduced tooth size. This challenge is heightened by the increased likelihood that these features will occur in patients who have agenesis. This article describes a new approach that has been shown to minimize such a loss of anchorage. The technique is called hemisection and involves buccolingual sectioning of the second deciduous molar, followed by removal of its distal half. As necessary, the mesial half is also removed, and space closure can be completed. The advantages, philosophy, and technique are discussed in detail.
ISSN:0889-5406
1097-6752
DOI:10.1016/j.ajodo.2004.12.001