title: Clinical repair of an osseous defect associated with a cemental tear: a case report.
abstract: Cemental tears have been described as detachment of cementum caused by trauma or aging. They often result in severe periodontal lesions that may necessitate the extraction of the affected tooth. This case report describes the clinical resolution of a periodontal lesion associated with a cemental tear. A maxillary central incisor was subjected to endodontic treatment twice with no resolution of a deep distobuccal pocket and a palatal sinus tract from its apical region. The preoperative differential diagnosis for the condition present on the tooth included a vertical fracture and a combined periodontal-endodontic lesion. Surgical exploration of the area revealed a cemental tear on the apical third of the tooth. The cementum fragments were removed, root-end resection was performed, and the osseous lesion was treated with an osseous graft and guided tissue regeneration. Clinical examination of the area 1 year after surgery revealed resolution of both the prior pocket and sinus tract. Radiographic examination of the area showed increased radiopacity in the area of the original lesion, suggesting bone fill.
authors.affiliation: Division of Associated Clinical Specialties, UCLA School of Dentistry, Los Angeles, California 90095, USA. pauloc@dentnet.dent.ucla.edu
authors.forename: Paulo M
authors.initials: PM
authors.lastname: Camargo
authors.forename: Flavia Q M
authors.initials: FQ
authors.lastname: Pirih
authors.forename: Lawrence E
authors.initials: LE
authors.lastname: Wolinsky
authors.forename: Vojislav
authors.initials: V
authors.lastname: Lekovic
authors.forename: Heidi
authors.initials: H
authors.lastname: Kamrath
authors.forename: Shane N
authors.initials: SN
authors.lastname: White
mesh_terms: D016301:Alveolar Bone Loss / Q000209:etiology* / Q000601:surgery; D001047:Apicoectomy; D001857:Bone Matrix / Q000637:transplantation; D018786:Bone Substitutes / Q000627:therapeutic use; D003739:Dental Cementum / Q000293:injuries* / Q000601:surgery; D003751:Dental Fistula / Q000209:etiology / Q000601:surgery; D005500:Follow-Up Studies; D016557:Guided Tissue Regeneration, Periodontal; D006801:Humans; D007180:Incisor / Q000293:injuries* / Q000601:surgery; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D010514:Periodontal Pocket / Q000209:etiology* / Q000601:surgery
chemical_list: D018786:Bone Substitutes; D008567:Membranes, Artificial