Cemental Tears: Challenges in the Diagnosis and Management of an Unusual Finding Associated with Rapid Localized Periodontal and Peri-radicular Bone Loss

A cemental tear is a rare form of root surface fracture whereby a fragment of cementum partially or completely detaches from the root surface at the cemento-dentinal junction or within the body of cementum. Tears are most prevalent in incisors and lead to the breakdown of periodontal issues. Owing to challenges involved in diagnosis, cemental tears may be misdiagnosed because associated clinical and radiographic features closely resemble those seen in vertical root fractures, periodontal abscesses and endo-periodontal lesions. If incorrectly diagnosed, inappropriate and delayed management may result in treatment failure and tooth loss.