Cemental tear: diagnostic challenges, imaging features and classification

Abstract

Cemental tear, or cementum delamination, occurs when there is a fracture at the cementum-dentin junction of the root, meaning a small fragment of cementum detaches from the root partially or completely, remaining in the periodontal ligament space, and potentially causing an area of bone resorption. The etiological factors of this condition are still unknown, however, some authors have suggested predisposing factors, including age, sex, history of dental trauma, parafunctional habits, and pulp vitality. Cemental tear is considered difficult to diagnose due to its clinical characteristics resembling those of other pathologies. Nevertheless, the authors emphasize that the diagnosis must be early and accurate to ensure effective treatment with a good prognosis. For this reason, they proposed a classification for cemental tears and advocate for the use of cone-beam computed tomography (CBCT), which allows for a more precise evaluation of the dental element in any imaging plane, leading to an accurate diagnosis and determining a treatment plan whose main objective is the complete removal of the cemental fragment.