Cemental tear: An overlooked finding associated with rapid periodontal destruction. A case series

A. Pedercini, D. F. Weitz, J. D. Heyse, C. Pedercini, I. Kormas, I. G. Koutlas, D. K. Johnson, S. B. McClanahan

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Cemental tear is defined as cementum fragment completely or partially detached from the root surface, and it has been associated with localized rapid periodontal breakdown. Although history of trauma and/or attrition may be risk factors, the etiopathology of cemental tear remains unknown. This case series aims to discuss the clinical, radiographic and histopathologic features of cemental tears to aid clinicians in making differential diagnosis. Three teeth from three patients presenting a periradicular lesion underwent an exploratory surgery to determine the cause and provide treatment. Soft and hard tissue biopsies were obtained from each lesion and forwarded for histopathologic evaluation. Two patients received a guided tissue regeneration (GTR) procedure, which allowed the tooth to be retained. One patient received an extraction with simultaneous guided bone regeneration (GBR) due to a hopeless prognosis of the tooth. The results after histopathologic evaluation yielded a final diagnosis of cemental tear for all three patients. Cemental tears may be overlooked, and therefore, they should be included in the differential diagnosis of periapical periodontitis, endodontic-periodontal lesion and vertical root fracture (VRF).

Original languageEnglish (US)
Pages (from-to)S82-S87
JournalAustralian Dental Journal
Volume66 Suppl 1
Issue numberS1
Early online dateApr 17 2021
StatePublished - May 3 2021

Bibliographical note

Funding Information:
The authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or nonfinancial interest in the subject matter or materials discussed in this manuscript.

Publisher Copyright:
© 2021 Australian Dental Association


  • Cementum
  • diagnosis
  • pathogenesis of periodontal disease(s)
  • prognosis
  • treatment


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