Hemisected tooth crown lengthening: what it is and why it is done
Hemisected tooth crown lengthening is a way of keeping a back tooth that would otherwise be extracted. A molar, most often a lower one, has two roots. When decay, a fracture or gum disease has destroyed one root but the other is still sound, the dentist can separate the tooth through the middle (hemisection), remove the damaged half with its root, and keep the healthy half. Crown lengthening is then used to reshape the gum and sometimes a little bone around the remaining half, so that enough healthy tooth shows above the gum for a crown to grip. Dental clinics in Turkey carry out this combination as part of tooth-saving and restorative work.
It is a specialist procedure, not a routine one, and it is only suitable for a small number of teeth. This guide explains how it works, what the evidence says, what it costs compared with the UK, US and Germany, how long to allow for healing, and how to check a clinic. For the wider range of options see our dental treatments in Turkey.
What is a hemisected tooth, and how is it different from a normal crown lengthening?
A hemisected tooth is a multi-rooted molar that has been split so that only one root and its half of the crown remain. Plain crown lengthening exposes more of a tooth that is still whole, for example when a crown has broken off at gum level. In the hemisected version the remaining half is smaller and sits at an unusual angle, so there is less to hold a restoration. Reshaping the gum and bone around it gives the dentist a clean, dry margin to work against and leaves room for the gum to attach without touching the new crown, which is what the body needs in order to keep the area healthy.
Which teeth can be hemisected?
The method is used mainly on lower first and second molars, which have a mesial and a distal root, and occasionally on upper molars, where a related operation removes one of three roots (root resection). The dentist looks for four things: a remaining root with enough bone around it, a root canal that can be cleaned and filled, a split between the roots (the furcation) that can be kept clean, and a tooth that matters for your bite. Teeth with very short roots, a fracture running down into the remaining root, or advanced gum disease throughout the mouth are normally not suitable.
How is a hemisected tooth treated, step by step?
The order matters, and most plans follow it:
- Assessment: an X-ray, usually a 3D scan, shows root shape, bone level and the furcation.
- Root canal treatment: the root that will be kept, and often both roots, receive root canal treatment first, because the pulp cannot be treated once the tooth is split.
- Hemisection: under local anaesthetic the dentist cuts the tooth through the furcation with a bur and removes the damaged root and crown portion.
- Crown lengthening: the gum is lifted, a small amount of bone is reshaped if needed, and the gum is stitched back.
- Preparation and crown: after the gum has settled, the remaining half is shaped and a temporary crown placed, followed by the final crown. A gap left behind can be filled with a dental bridge or an implant.
The surgical visit takes roughly an hour. Planning and root canal work add separate sittings, so patients travelling from abroad usually split the care into one trip for the preparatory and surgical steps and a second, or a longer single trip, for the crown.
Does hemisection actually work? What the evidence says
It can, in carefully chosen teeth. Reviews of root resection and hemisection report that many treated teeth stay in function for ten years or more, and that the reasons for failure are well known: a vertical root fracture in the remaining root, new decay at the margin, a failing root canal and gum disease around the cut surface. Implants have good survival figures too, and several comparisons find that the two approaches perform similarly when the tooth is well chosen, although the evidence on hemisection is mostly from smaller studies. A good dentist will tell you honestly whether your tooth is a candidate or whether extraction would be the more predictable route.
Hemisection, extraction and implant, or a bridge?
Hemisection keeps part of your own tooth, which preserves bone and avoids an artificial root. An implant replaces the whole tooth and does not depend on the remaining root surviving; see our guide to dental implants. A bridge uses neighbouring teeth as anchors and needs them to be reduced.
| Option | Best suited to | Typical limits |
|---|---|---|
| Hemisection with crown lengthening | A molar with one healthy root and good bone around it | Risk of root fracture or decay in the kept half; needs very good cleaning |
| Extraction and implant | A tooth that cannot be saved, with enough bone | Several months of healing; bone grafting may be needed |
| Extraction and bridge | Healthy neighbouring teeth that already need crowns | Neighbouring teeth are cut down; cleaning under the bridge |
Hemisected tooth crown lengthening cost in Turkey compared with the UK, US and Germany
The ranges below are approximate figures for the surgical part (hemisection and crown lengthening of one tooth) and exclude the final crown, which is priced separately. They are not hospital quotes. A written, itemised quote from the clinic is the only reliable figure.
| Country | Approximate cost range (one tooth, without final crown) |
|---|---|
| Turkey | €250 – €900 |
| United Kingdom | €800 – €2,200 |
| United States | €1,000 – €3,200 |
| Germany | €600 – €1,900 |
What changes the price: whether a root canal is needed or already done, a specialist periodontist or general dentist performing the surgery, whether bone reshaping or a graft is included, the 3D scan, and the crown material chosen afterwards (metal-ceramic or zirconia). A clear quote lists each of these separately, including the number of visits and the follow-up checks.
Who is a good candidate for hemisected tooth crown lengthening?
Good candidates have a molar with one strong root, good bone support, healthy gums elsewhere in the mouth, and are willing to clean carefully around a tooth with a reshaped gum line. It is less suited to people who smoke heavily, have untreated gum disease, grind their teeth hard without a night guard, or have a split or cracked root, since these all reduce the chance that the kept half will last. People on blood thinners, bisphosphonates or with uncontrolled diabetes need a medical review first.
Hemisected tooth recovery: what to expect after crown lengthening
The gum is tender for several days, with some swelling and a little bleeding at first. Most people manage with ordinary painkillers, a soft diet for a few days and a prescribed antibacterial mouthwash, and return to normal activities the next day. The gum needs about four to eight weeks to settle before the final crown impressions, because gum height can shift during healing. A temporary crown protects the tooth meanwhile. Once the final crown is fitted, regular hygiene visits and interdental brushing around the furcation are what keep the result stable.
Hemisected tooth before and after: what results look like
Photographs and X-rays show a single-rooted, narrower crown where a wide molar once stood, with a clean gum line around it. Chewing function is usually adequate for a stable tooth, but the crown is smaller than the original and the space between teeth must be kept clean. The result does not show whether the root will last: that depends on the quality of the root canal, the crown margin and your cleaning. Ask the clinic for X-rays of teeth treated in the same way after several years, not just freshly completed cases.
Risks and complications of hemisection and crown lengthening
Common effects are swelling, sensitivity to cold and a sore gum. Less common problems include a fracture of the remaining root, infection or an abscess, bone loss around the cut area, gum recession that makes the crown margin visible, loosening of the crown and decay at the margin. Any operation under local anaesthetic also carries a small risk of allergic reaction. Professional bodies such as the American Academy of Periodontology and the NHS advise that gum surgery is done by a trained clinician in a clean, regulated setting, with the risks explained beforehand. Ask what the clinic does if the tooth fails and what an implant would then cost.
How to choose a clinic, and what to ask before you travel
Look for a dentist or periodontist registered in Turkey who does these operations regularly, a clinic that works from a 3D scan, and a written plan with prices for each stage. Warning signs are an immediate recommendation to extract every doubtful tooth, a very low price with no breakdown, and no plan for follow-up at home. Read how our process works and send your X-rays through our free quote page for a written plan. Useful questions:
- Is my tooth really suitable for hemisection, and what is the alternative?
- Will the root canal be done before surgery, and by whom?
- Does the price include the crown, the temporary crown and the 3D scan?
- How many visits or nights are needed, and what if the gum needs longer to heal?
- Who treats a problem after I am home, and what does that cost?
Hospitals with Dental Treatments in Turkey
Frequently asked questions
A hemisected tooth is a two-rooted molar that has been cut through the middle so that the damaged root and its half of the crown are removed. The healthy half is kept and later covered with a crown, which lets the dentist avoid a full extraction.
The kept half is small and may sit below the gum, so there is not enough tooth above the gum for a crown to hold. Crown lengthening reshapes the gum and sometimes a little bone to expose more healthy tooth.
Approximate ranges for the surgery on one tooth are €250 to €900 in Turkey, against about €800 to €2,200 in the UK, excluding the final crown. The clinic confirms its price in a written quote.
Many well-chosen teeth last ten years or more, but there is a real risk of root fracture, decay at the crown margin or gum disease. Careful cleaning and a well-made crown improve the odds.
Neither is right for everyone. Hemisection keeps your own tooth and bone, while an implant replaces the tooth entirely and does not depend on the remaining root. Your dentist should explain which is more predictable for your tooth.
The area is numbed with local anaesthetic, so you should feel pressure but not pain. Afterwards the gum is sore for several days and is usually managed with simple painkillers.
The gum is tender for about a week, and takes roughly four to eight weeks to settle before the final crown is made. Most people return to normal activities the next day.
Before, a wide molar with two roots; after, a narrower tooth with a crown and a clean gum line, often with a small space where the removed half was. X-rays show the single remaining root.
Yes. The gap can be left, bridged to a neighbouring tooth or filled with an implant, depending on bone, cleaning access and your bite. Your dentist should plan this before surgery.
The surgical step usually needs a visit of a few days, followed by checks and the crown. Because gum healing takes weeks, many clinics split the work into two trips or plan a longer stay.