Multidisciplinary approach for management of cemental tear with apical periodontitis:
A case report

Sung, Kun-Hwa; Cho, Hye-Jin; Jo, Hyung-Hoon; Park, Tae-Young

doi:2022.60.11.704

J Korean Dent Assoc > Volume 60(11); 2022 > Article

CASE REPORT

The Journal of The Korean Dental Association 2022;60(11):704-712.
DOI: https://doi.org/10.22974/jkda.2022.60.11.003 Published online October 31, 2022.

근단 치주염을 동반한 백악질 열리 증례에 대한 다학제적 접근: 증례보고

성건화

, 조혜진

, 조형훈

, 박태영

조선대학교 치과대학 치과보존학교실

Multidisciplinary approach for management of cemental tear with apical periodontitis: A case report

Kun-Hwa Sung

, Hye-Jin Cho

, Hyung-Hoon Jo

, Tae-Young Park

Department of Conservative Dentistry, School of Dentistry, Chosun University , Gwang-ju, Korea

Correspondence: Tae-Young Park, Tel: +82-62-220-3840, Fax: +82-62-223-9064,
Email: conschosun@chosun.ac.kr

Received: 5 July 2022 • Revised: 6 July 2022 • Accepted: 26 September 2022

Abstract

Objectives
Cemental tear is a specific type of root surface fracture that can lead to rapid periodontal attachment loss. Tooth associated with cemental tear show mobility of tooth, resorption of alveolar bone, and inflammation that persists even after root canal treatment. Cemental tears are difficult to diagnose when characteristic fractures are not observed on radiographs, and often misdiagnosis as periapical or periodontal lesions. refore, an accurate diagnosis is essential for suc-cessful treatment of cemental tears and a multidisciplinary approach that involves both endodontic periodontal treatment, and periodontal surgery is required. The aim of this case report is to present the treatment and outcome of cemental tear which was managed with two differ-ent surgical treatment regimes. In the first case, after conventional endodontic treatment, cemental fragment was removed through open flap surgery, and regeneration treatment was performed by guided tissue regeneration (GTR) and bone graft. In the second case, after conventional endodontic treatment, apicoectomy and removal of cemental fragments were performed through replantation of tooth, followed by guided tissue regeneration (GTR) and bone graft. In both cases, follow-up of more than 6 months was performed, symptoms subsided and recovery of periapical alveolar bone was observed on radiographs.

Key Words: cemental tear; guided tissue regeneration; apical periodontitis; replantation