(TC35) Cemental Tears Associated with Endodontic Lesions: Regeneration Through Endodontic Microsurgery

Abstract: A cemental tear is a unique type of root surface fracture that may cause marginal periodontal and periapical tissue destruction. The treatment objective of teeth with cemental tears is to regenerate periodontal/apical tissues for functional retention of the affected tooth. Based on the location of the cemental tear and the potential endodontic etiology, various treatment options have been reported in the literature, consisting of nonsurgical scaling and root planing, surgical debridement with periodontal/apical surgery, surgical debridement combined with guided tissue regeneration (GTR) and bone grafting, and extraction. More recently, treatment techniques using various biocompatible scaffolds for management of teeth with cemental tears are being reported. BioXclude® (Snoasis Medical Inc., Golden, CO, USA) is a dehydrated human deepithelialized amnion-chorion membrane (ACM) that can serve as a barrier in various regenerative procedures in dentistry. It contains biological factors, which aid in healing, promote angiogenesis, reduce inflammation, and accelerate flap reattachment. It also possesses inherent antibacterial properties. Considering these properties, this membrane has a potential to be utilized for periodontal tissue regeneration. The purpose of this table clinic is to describe two different forms of regeneration - surgical pulp regeneration and periodontal regeneration - during an endodontic microsurgery using this ACM when managing teeth with cemental tears and concurrent lesions of endodontic origin. Clinical cases will be presented to illustrate the treatment protocols and outcomes. With this knowledge, clinicians will be able to better manage teeth with cemental tears that require endodontic treatment.