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If left untreated, an inflammatory periodontal disease eventually leads to attachment loss. This may have an impact on a multi-rooted tooth's bifurcation or trifurcation. The division of a tooth with two roots into two distinct parts is known as hemisection.  Hemisection  is the term used to describe the removal or separation of a two-rooted tooth's root and crown, most likely a mandibular molar. Compared to other treatment options, hemi-sectioning the affected tooth can help preserve the tooth's structure and alveolar bone. Careful selection of cases is essential for the long-term success of the procedure. In this case report, in contrast to the more common option of extracting the natural tooth, a treatment option is discussed for molars with extensive decay that threatens tooth loss. Therefore, this option should be discussed with patients when deciding on a course of treatment, and it may be a good substitute for extraction and implant therapy, particularly in cases of advanced endo-perio lesions., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Khetan et al.)