Clinical Application Of Corrective Surgery

Objective:To evaluate the clinical effect of application of corrective surgery,including hemisection and root seperation.Methods:Collect 10 cases with either severe furcation involvement or root fracture or pulp chamber floor perforation.With careful analysis of symtoms,clinical exams and preoperative radiograph,a correct diagnosis was made. The roots reserved should be completed the perfect root canal therapy and initial periodontal therapy. (including scaling and root planning). Those teeth without periodontal disease was observed in one week after the root canal therapy. With no symptoms the teeth were performed hemisection or root seperation. the restoration were done 6-8 weeks after Root seperation or 3 months after tooth hemisection.Whether the remaining teeth can be reserved according to the following criteria:(1) tooth mobility is no more than degree I, x-ray shows alveolar bone loss does not exceed the root length of 1/2. (2) root length is more than 7mm, the end of root or crow is at least 2mm above gingival margine. (4) no periodontal pockets, no bleeding on probing. (3) reduction or healing of periapical lesions. Then the restoration should be desiged according to the condition of remaining tooth and adjacent teeth.Result:10 cases in the collection,5 cases diagnosed as severe furcation involvement or large sizes perforation of pulp chamber floor, which had sufficient periodontal supportive tissues of muti-roots,were treated by root seperation.(both of two roots were reserved).the other 5 cases diagnosed as root fracture or severe furcation involvement with inadequate periodontal supportive tissues of one root were performed by hemisection(one was removed,the other healthy one was reserved).for 5 cases treated by root seperation,proper fix prothesises were complished after six or eight weeks. for the other 5 cases treated by hemisection, proper prothesises were done after 3 months. Among 10 cases,. a full crown was designed in 2 cases, cantilever fixed bridge in 1 case, rigid fixed bridge in 3 cases, linked crown in 4 cases. After repair of the prosthesis,all of 10 patients felt comfortable and had good retention, good chewing function.Conclusion:with strict cases selection,optimal root canal thrapy and periodontal therapy (including scaling and root planning), proper prothesises design and good maintenance care,a good treatment outcome can be achived.