Method: Cases were consecutively collected from the patient panels of the authors.
Result: We report 14 new cases of cemental tear, 8 in males; 6 in females. The average age at diagnosis was 66 years, with a range of 52-90 years. All cases were associated with vertical or D-shaped, moderately well demarcated, symptomatic radiolucencies which could not be probed; 10 cases were isolated to the apical half of the affected root. All cases were associated with viable teeth and anterior maxillary incisors were most often affected (n = 7), although no alveolar site was spared. Histopathology showed fibrous scar formation around 3 cementum fragments and chronic inflammation with fibrosis (chronic fibrosing osteomyelitis) in all other cases; 3 submitted teeth all showed traumatic loss of cementum. Nine cases required extraction of the affected tooth. A total of 25 in situ tears where seen in a microscopic review of 750 extracted teeth without clinical evidence of cemental tear. Tear patterns will be reviewed, including two teeth with almost half of the cementum torn of the near-apical root.
Conclusion: Cemental tears are not resorbed in vivo and produce symptomatic, low grade chronic fibrosing osteomyelitis of the adjacent bone, characterized by a vertical radiolucency adjacent to the root. Depending on presentation, extraction of the affected tooth may not be necessary.
Keywords: Bone, Radiology, Root and Trauma-fracture