Background: Cemental tear involves complete or incomplete separation within the root surface along the cementodental junction that can lead to loss of periodontal attachment. This case report showed the course of regenerative treatment for alveolar bone defects with cemental tear in a right lower central incisor (#25).
Case: Cone-beam computed tomography (CBCT) and clinical examinations including pulp vital testing and pocket probing depth showed a cemental tear with a severely labial alveolar bone defect, but no endodontic lesions in #25, which had a sinus tract at the labial site, in a 75-year-old woman. This cemental tear was diagnosed as Class 3/Stage C based on the classification by Lee et al., 2021. Clinical procedure and outcome: Clinical management of this case based on the treatment decision-making (Lee et al., 2021) included complete removal of the torn fragments and inflamed granulation tissues, and periodontal regenerative therapy. Recombinant human fibroblast growth factor (rhFGF-2) was used as a biologically regenerative molecule. The treatment yielded the gain of 7-mm-clinical attachment level and reconstruction of the labial bone wall and proximal bone walls 2 years after the surgery. In particular, the regenerated labial bone had a similar height to the lingual bone. Histopathological examination of the removed cemental fragment and granulomatous tissue showed they both had bacterial colonies.
Conclusion: Successful clinical and radiographic outcomes for severe periodontal tissue destruction with cemental tear were achieved through the clinical management based on the new classification and treatment decision-making by Lee et al., 2021.
