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Cemental tear - a series of 14 cases of surgical periodontal treatments with a follow-up of up to ten years

British Dental Journal volume 238, pages 793–796 (2025)Cite this article

Abstract

Cemental tear is a relatively uncommon condition with low awareness among dentists. It can mimic other periodontal diseases as well as endodontic disease, and it should be part of the differential diagnosis. The total number of cases reported worldwide is still low and knowledge on conservative treatment prognosis is poor. This case series aims to report retrospectively the long-term results of teeth with cemental tear treated consecutively with periodontal surgery. Patients were managed between the years 2012-2023 in a specialist clinic in the north of Sweden. The treatment consisted of periodontal surgery with or without regenerative techniques, and when necessary, orthograde or retrograde endodontics. Fourteen patients (14 teeth), ranging from 36-85 years old, of which ten were male, were observed up to 131 months. Four teeth were extracted, all within the first 12 months, with clear signs of remaining infection. Three patients showed uncertain healing. One tooth was rescheduled for operation but in another location of the same tooth. The other six patients successfully healed, one after a re-operation. Conservative treatment of cemental tears has an acceptable prognosis, even in severely damaged teeth.

Key points

  • Cemental tear is a type of periodontal breakdown that can cause a periodontal abscess. It is a partial detachment of cementum from the root surface. It can mimic other periodontal diseases, endodontic pathology and vertical root fractures.

  • Cemental tear's incidence is low. Diagnosis can only be made if clinicians are aware of the condition.

  • Periodontal surgery of cemental tear has an acceptable prognosis, even in severely damaged teeth. Teeth that survive after one year have a relatively good long-term prognosis.

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Acknowledgements

The authors would like to thank Maria Granevik Lindström, Robert Carroll, Emma Wigsten and all dentists they work with in Norrbotten for their involvement in the follow-ups.

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Authors and Affiliations

  1. Department of Endodontics, Tandvårdens Kompetenscentrum (Dental Specialist Clinic), Region Norrbotten (Norrbotten County Council), Luleå, Sweden; Department of Endodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Fernando J. Mota de Almeida

  2. Department of Periodontology, Tandvårdens Kompetenscentrum, Region Norrbotten, Luleå, Sweden

    Anna Arespång

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  1. Fernando J. Mota de Almeida
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  2. Anna Arespång
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Contributions

FJMA contributed to conceptualisation, investigation (data collection), curation of data, and writing (original draft; review and editing). AA contributed to conceptualisation, investigation (data collection), curation of data, and writing (review and editing).

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Correspondence to Fernando J. Mota de Almeida.

Ethics declarations

The authors declare that they do not have any conflict of interests. Ethics review by the Swedish Ethical Review Authority was waived, as this is a descriptive report of cases in common practice and is not considered research. Treatments were conducted with the patients' oral informed consent, following standard Swedish practice. Written consent for the use of health data in publication was obtained when feasible; when this was not possible, oral consent was accepted. Description of cases are not enough to permit the identification of the patients.

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Mota de Almeida, F., Arespång, A. Cemental tear - a series of 14 cases of surgical periodontal treatments with a follow-up of up to ten years. Br Dent J 238, 793–796 (2025). https://doi.org/10.1038/s41415-025-8492-y

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