Treatment Outcome of the Teeth with Cemental Tears

• Published in: Journal of endodontics Vol. 40; no. 9; pp. 1315 - 1320
• Main Authors: Lin, Hsueh-Jen, DDS, MS, Chang, Mei-Chi, MS, PhD, Chang, Shu-Hui, PhD, Wu, Chen-Tsai, DDS, Tsai, Yi-Ling, DDS, MS, Huang, Chih-Chia, DDS, MS, PhD, Chang, Shu-Fang, MS, Cheng, Ya-Wen, DDS, MS, Chan, Chiu-Po, DDS, MS, Jeng, Jiiang-Huei, DDS, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2014
• Subjects: Aged; Aged, 80 and over; Alveolar Bone Loss - etiology; Apical periodontitis; apicocoronal location; Bone Transplantation - methods; cemental tear; Cohort Studies; Debridement - methods; Dental Cementum - injuries; Dental Scaling - methods; Dentistry; Endocrinology & Metabolism; Female; Guided Tissue Regeneration, Periodontal - methods; Humans; Male; Middle Aged; Periapical Diseases - etiology; periodontitis; Periodontitis - etiology; predictors of treatment outcome; Root Planing - methods; Surgical Flaps - surgery; Tooth Apex - injuries; Tooth Cervix - injuries; Tooth Extraction - methods; Tooth Fractures - therapy; Tooth Replantation - methods; Tooth Root - injuries; Treatment Outcome; Apical periodontitis; cemental tear; predictors of treatment outcome; apicocoronal location; periodontitis
• ISSN: 0099-2399; 1878-3554
• DOI: 10.1016/j.joen.2014.05.012

Abstract Introduction A cemental tear is a special type of surface root fracture noted in combination with periodontal and/or periapical bony destruction. We hypothesized that clinical characteristics and treatment techniques may affect the prognosis of teeth with cemental tears. Methods Treatment outcome for the teeth with a cemental tear was assessed in a multicenter cemental tear study project. Of the 71 teeth with cemental tears, 38 teeth (53.5%) were extracted. The remaining 33 teeth (46.5%) were examined for a treatment outcome of healed, questionable, or failed. Results Outcome assessment found that 51.5% (17/33), 42.4% (14/33), and 6.1% (2/33) of teeth were classified as healed, questionable, and failed, respectively. Additive bivariate analysis indicated a significant difference between treatment outcome and the length ( P  = .01) and apicocoronal location ( P  = .02) of the separated root fragments. Logistic regression analysis found that treatment technique and apicocoronal location of cemental tears may affect the treatment outcome. The percentage of healed cemental tear cases located in the apical, middle, and cervical third of roots was 11.1%, 66.7%, and 60.0%, respectively. By surgical management, 57.7% of cemental tears were healed, whereas only 28.6% cases were healed after nonsurgical treatment. Conclusions Most teeth with cemental tears can be retained to function by nonsurgical and surgical periodontal and endodontic treatment. Clinical diagnosis and treatment of cemental tears should also consider the apicocoronal location and the type of treatment technique to improve outcomes.