• The Journal of the Korean dental association
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• v.54 no.5
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• pp.365-373
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• 2016

Purpose: Cemental tear is a specific type of root surface fracture characterized by a complete separation of a cemental fragment along the cementodentinal junction or a partial split within the cementum along an incremental line. It is suggested to be a factor for periodontal or periapical tissue destruction. The aim of this study is to present a diagnosis and treatment of cemental tear associated with periapical lesion with root canal treatment and regenerative periodontal surgery. Treatments: A 60-year-old male who had a history of sports trauma on the mandibular right central incisor about 10 years ago presented with apical cemental tear. Clinical examination showed a slightly dark yellowish discoloration and sinus tract that was located on the apical labial mucosa. The mobility and percussion were also assessed on the diseased tooth and recorded as $Miller^{\circ}{\phi}s$ Class II and tenderness to percussion. The probing depth was within the normal limit (<3 mm). Radiographic examination revealed a radiolucent lesion at the apical area and extended to distal aspect of the tooth along the fragment of cemental tear. After root canal treatment, periapical surgery was performed. The bony defect was exposed and then the detached root fragment was removed. Apical root resection and retrograde filling with Mineral Trioxide Aggregate (MTA) were accomplished and the bony defect was filled with deproteinized bovine bone mineral (DBBM) and covered with biodegradable collagen membrane. Results: After 9-month follow-up, healing of the mandibular right central incisor was uneventful and no swelling, purulence or pain was revealed in the associated area. Probing pocket depth was favorably stable, and the tooth mobility was decreased to the Miller's Class I. Conclusions: Apical cemental tear associated periapical lesion could be successfully treated with removal of the detached cementum in combination with apical surgery and GTR procedure.

• Oral Biology Research
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• v.42 no.4
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• pp.248-253
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• 2018

Cemental tears are uncommon form of root fracture that can lead to rapid localized periodontal attachment loss. Studies have described periodontal breakdown as being associated with the separation of the cementum from the underlying tooth structure. The aim of this case report is to assess the outcome of treatment of cemental tear with several surgical treatment regimens. Three patients with cemental tear were treated with different surgical method. In all three cases, the cemental tear occurred on maxillary right central incisors. In each case, the root fragment were removed, the localized defect was treated using different surgical methods including guided tissue regeneration and bone graft followed by scaling and root planting. In all three cases, symptoms subsided after the treatment and clinical attachment level was improved up to 2 mm at 3 month after surgery. Both conventional and regenerative periodontal surgery could achieve successful outcomes.

• Journal of Periodontal and Implant Science
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• v.38 no.3
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• pp.551-556
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• 2008

Purpose: Cemental tear is an uncommon form of root fracture that can lead to rapid localized attachment loss. When it is exposed in the periodontal pocket, it should be removed to prevent accumulation of dental plaque and calculus. Material and Methods: 2 patients were diagnosed as a cemental tear and they were treated with conventional flap operation and subgingival curettage. Additional treatments such as bone graft or guided tissue regeneration were not performed. Result: Symptoms subsided after the treatment. Periodontal pocket has been reduced but no gain of clinical attachment was observed. Remnant of cemental fragment remained after curettage. However, periodontal pocket was stably maintained and there was no recurrence. Conclusion: Periodontal attachment loss associated with cemental tear can be successfully treated with conventional periodontal surgical and nonsurgical procedures.