CementalTear Predisposing Factors, Clinical Signs Symptoms, Diagnosis and its Management

Authors

  • Shama Asghar

Keywords:

Cemento-dentinal junction, Apical lesion, Fracture, Cemental tear,Periodontal disease

Abstract

A cemental tear is a rare condition in which a total or partial detachment of the cementum occurs along the root surfaceat the cemento-dentinal junction and is associated with moderate to severe periodontal attachment loss. Literature regarding this article was searched fromPub Med, Medline and Google during the period of Jan 2008- Dec 2012.Cemento-dentinal tear is more frequently seen in older men above 60 years, single-rooted vital or nonvital teeth, particularly the incisors and premolars areinvolved. Other significant etiological factors are traumatic occlusion, poor ability of tissue healing due to age and structural weakness of the cementum. Its diagnosis can be confirmed by clinical signs and symptoms,(presence of localized periodontal pockets with exudates and localized pain) by radiographic findings(as a radiopaque fragment) and surgical inspection. The treatment of cemental tears involves scaling and root planning, open flap debridement, bone graft, regenerative tissue guide, apical surgery and dental extraction

References

Ishikawa I, Oda S, Hayashi J, Arakawa S. Cervical cemental tears in older patients with adult periodontitis: case reports. J Periodontol 1996;67:15-20.

Lin HJ, Chan CP, Yang CY. Cemental tears: clinical characteristics and its predisposing factor. J Endod 2011;37:611-8.

Stewart ML, McClanahan SB. Cemental tear: a case report. Int Endod J 2006;39:81-6.

Chou J, Rawal YB, O'Neill JR, Tatakis DN. Cementodentinal tear: a case report with 7 year follow up. J Periododntol 2004; 71: 1761-6.

Lin H J, Chang S H, Chang M C, Tsai Y L, Chiang C P, Chan C P et al. Clinical fracture sites, morphologic and histopathologic characteristics of cemental tear: Role in endodontic lesions. J Endod 2012;38:1058-62.

Bosshardt DD, Selvig KA. Dental cementum: the dynamic tissue covering of the root. Periodontol 2000;13:61-75.

Haney JM, Leknes KN, Lie T, Selvig KA, Wikesj€o UME. Cemental tear related to rapid periodontal breakdown: a case report. J Periodontol 1992;63:220-4.

Llena P M, Forner N L, Barbero N I. Vertical root fracture in endodontically treated teeth: a review of 25 cases. Oral Surg Oral Med Oral Pathol Oral RadiolEndod 2001; 92:553-5.

Leknes KN, Lie T, Selvig KA. Cemental tear: a risk factor in periodontal attachment loss. J Periodontol 1996;67:583-8.

Eid AA, Komabayashi T, WatanabeE, Shiraishi T, Watanabe I. Characterization of the mineral trioxide aggregate-resin modified glass ionomer cement interface indifferent setting conditions. J Endod 2012;38:1126-9.

Camargo PM, Pirih FQM, Wolinsky LE, Lekovic V, Kamrath H, White SN. Clinical repair of an osseous defect associated with a cemental tear: a case report. Int J Periodont Restor Dent 2003;23:79-85.

Tai TF, Chiang CP, Lin CP, Lin CC, Jeng JH. Persistent endodontic lesion due to complex cementodentinal tears in a maxillary central incisor: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103:e55-60.

Noma N, Kakigawa H, Kozono Y, Yokota M. Cementum crack formation by repeated loading in vitro. J Periodontol 2007;78:764-9.

Lyons CT, Peacock MK, Cuenin MF, Swiec GD, Dickey DJ. Severe localized periodontal destruction associated with cervical cemental separation. Gen Dent 2005;53:212-4.

Tulkki MJ, Baisden MK, McClanahan SB. Cemental tear: a case report of a rare rootfracture. J Endod 2006;32:1005-7.

Kaur S, Kumar S, Mishra R, Gera A, Gupta H. Cemental Tear: An Un-usual Case Report. Indian Journal of Dental Sciences 2012;4:84-6.

Grant D, Bernick S. The periodontium of ageing humans. J Periodontol 1972;43:660-7.

Blieden TM. Tooth-related issues. Ann Periodontol 1999;4:91-7

Chan CP, Lin CP, Tseng SC, Jeng JH. Vertical root fracture in endodontically versus nonendodontically treated teeth. A survey of 315 cases in chinese patients. Oral Surg Oral Med Oral Pathol Oral RadiolEndod 1999; 87:504-7.

Tames A, Fuess Z, Lustig J, Kaplavi J. An evaluation of endodontically treated vertically fracture teeth. J Endod 1999; 25: 506-8.

Marquam B. Atypical localized deep pocket due to a cemental tear: a case report. J Contemp Dent Pract 2003; 4: 52-64.

Leknes KN. The influence of anatomic and iatrogenic root surface characteristics on bacterial colonization and periodontal destruction: a review. J Periodontol 1997;68:507-16.

Yamamoto T, Domon T, Takahashi S, Islam MN, Suzuki R, Wakita M. The structure and function of the cemento-dentinal junction in human teeth. J Periodont Res 1999;34:261-8.

Brunsvold MA, Lasho DJ. Cemental tears related to severe localized periodontal disease. Pract Periodontics Aesthet Dent 2000;12:536,539-40.

Gran D A, Chase J,Bernick S. Biology of the Periodontium in Primates of the Galago Species: I. The Normal Periodontium in Young Animals. II. Inflammatory Periodontal Disease. III. Lability of Cementum. IV. Changes in Ageing. V. Ankylosis: Types and Sequential Events. Journal of Periodontology 1973; 44:540-50.

Holton W L, . Hancock E B ,. Pelleu G B Jr. Prevalence and Distribution of Attached Cementicles on Human Root Surfaces. Journal of Periodontology 1986;57: 321-4

John V, Warner NA, Blanchard SB. Periodontal-endodontic inter disciplinary treatment-a case report. Compend ContinEduc Dent 2004;25:601-6.

Rotstein I, Simon JH. Diagnosis, prognosis and decision-making in the treatment of combined periodontal-endodontic lesions. Periodontology 2000 2004;34:165-203.

Harrel SK, Wright JM. Treatment of periodontal destruction associated with a cemental tear using minimally invasive surgery. J Periodontol 2000;71:1761-6.

Watanabe C, Watanabe Y, Miyauchi M, Fujita M, Watanabe Y. Multiple cemental tears. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114:365-72.

Badersten A, Nilvéus R, Egelberg J. Effect of nonsurgical periodontal therapy. I. Moderately advanced periodontitis. J Clin Periodontol 1981;8:57-72.

Kuo T C, Cheng Y A, Lin C P. Clinical management of severe root resorption. Chin Dent J 2005; 24: 59-64

Severson J A, Moffett B C, Kokich V, Selipsky H. A Histologic Study of Age Changes in the Adult Human Periodontal Joint (Ligament). Journal of Periodontology 1978;49: 189-200.

Pauwels R, Beinsberger J, Collaert B . SEDENTEXCT Project Consortium. Effective dose range for dental cone beam computed tomography scanners. Eur J Radiol 2012;81:267-71.

Ludlow JB, Davies-Ludlow LE, White SC. Patient risk related to common dental radiographic examinations: the impact of 2007 International Commission on Radiological Protection recommendations regarding dose calculation. JADA 2008;139:1237-43.

Kasaj A, Gortan KA, Briseno MB, Willershausen B. Treatment of severe localized periodontal destruction associated with a cemental tear: a case report and review of the literature. Gen Dent 2009; 57: e 5-9.

Benatti BB, Carvalho MD, Gomes BP, de Toledo S, Nociti Junior FH, Nogueira-FilhoGda R. Importance of differential diagnosis in endodontic-periodontal lesions: case reports. Gen Dent 2003;51:246-8.

Cortellini P, Tonetti MS. Focus on intrabony defects: guided tissue regeneration. Periodontol 2000; 22:104-32.

Müller HP. Cemental tear treated with guided tissue regeneration: a case report 3 years after initial treatment. Quintessence Int 1999;30:111-5.

Sculean A, Schwarz F, Becker J, Brecx M. The application of an enamel matrix protein derivative (Emdogain) in regenerative periodontal therapy: a review. Med Princ Pract 2007;16: 167-80.

Needleman IG, Worthington HV, Giedrys-Leeper E, Tucker RJ. Guided tissue regeneration for periodontal infra-bony defects. Cochrane Database Syst Rev 2006; (2): CD001724.

Hsin YC, Wu CL, Lin SL, Chen CS. Treatment of cemental tear using intentional replantation. J Endod Sci 2011;21:49-54

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Published

2012-12-31

How to Cite

Asghar, S. . (2012). CementalTear Predisposing Factors, Clinical Signs Symptoms, Diagnosis and its Management. Journal of Bahria University Medical and Dental College, 2(2), 4–7. Retrieved from https://jbumdc.bahria.edu.pk/index.php/ojs/article/view/33

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Review Article

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