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Related Experiment Video

Updated: Jul 2, 2026

The Establishment of a Murine Mandibular Molar Extraction Socket Healing Model
04:19

The Establishment of a Murine Mandibular Molar Extraction Socket Healing Model

Published on: January 13, 2023

Tissue response in hemisectioned primary mandibular second molars.

Jenny Öhman1, Vini Rughwani2, Julia Naoumova3

  • 1Department of Oral Medicine and Pathology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Clinical Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden. jenny.ohman@odontologi.gu.se.

Acta Odontologica Scandinavica
|July 1, 2026
PubMed
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Hemisection of primary molars for congenital premolar absence can expose the pulp. Despite inflammation, the primary pulp-dentin complex shows remarkable regenerative capacity, forming tertiary dentin and maintaining vitality.

Area of Science:

  • Pediatric Dentistry
  • Dental Histopathology
  • Regenerative Endodontics

Background:

  • Congenital absence of mandibular second premolars affects ~3% of individuals, often bilaterally.
  • Interceptive hemisection of primary second molars aids mesial drift but risks prolonged pulp exposure.

Purpose of the Study:

  • To investigate the histopathological responses of pulp and mineralized tissues following hemisection of primary mandibular second molars.
  • To evaluate pulp vitality and regenerative capacity under prolonged exposure conditions.

Main Methods:

  • A single-center, blinded, prospective split-mouth randomized controlled trial was conducted in Sweden.
  • Histopathological analysis of mesial roots from 21 hemisected teeth examined inflammation, necrosis, fibrosis, and hard tissue formation.

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Last Updated: Jul 2, 2026

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  • Patients aged 7-12 with over-retained primary mandibular second molars were included.

    • Main Results:

    • Histopathology revealed varying degrees of pulpal inflammation (none in 14%, acute/subacute in 38%, chronic in 48%) and necrosis (24%).
    • Reparative tertiary dentin formation occurred in 48% (with capping) and 33% (without capping).
    • Despite histological findings, most cases remained asymptomatic, with three patients reporting symptoms during follow-up.

    Conclusions:

    • Prolonged pulp exposure post-hemisection stimulates tertiary dentinogenesis, preserving pulp vitality for up to 17 months.
    • The primary pulp-dentin complex demonstrates significant regenerative potential, even with histological signs of inflammation or necrosis.
    • Hemisection can be a viable interceptive strategy, highlighting the resilience of primary dental tissues.