The Progress And Case Reports Of Diagnosis And Treatment On Cemental Tears

[Purpose] To present four different cases with diagnosis of cemental tear. The differences in etiology, clinical diagnosis and treatment of cemental tears were described and discussed in order to provide guidance for clinical practice.[Method] Four patients of different ages presented with gingival swelling and other different complaints. Clinically, localized deep periodontal pocket and inflammation were noted on affected aspect in four cases. Radiographic examination revealed a prickle-like or flake-like structure and bone loss on the affected side of the involved tooth. Different treatment such as extraction, traditional periodontal initial therapy, periodontal flap surgery, no clinical intervention were given for different tooth mobility and bone loss.[Results] In the first two cases, cemental tear teeth were extracted for poor prognosis. In case 3, deep pockets recovered normal, while cemental tears in the distal aspect of tooth 21, has no abnormal feeling or clinical symptoms. In case 4, a periapical radiograph showed distal bone loss was interrupted, tooth also recovered normal mobility. Histopathological evaluation of the specimens with H&E staining all resulted in a definitive diagnosis of cemental/cementodentinal tears.[Conclusion]In summary, cementodentinal or cemental tears are unique, localized, tooth-related factors associated with attachment loss. Aging, trauma, occlusal overload are main etiological factors. Early diagnosis and appropriate treatment will avoid unnecessary tooth extraction and result in a better prognosis. Detailed clinical, radiographic examinations and explorative surgery may help to make a diagnosis of cemental tears while histopathological analysis is the only method for a definitive diagnosis.