Cemental Tear: Radiographic-clinical characteristics and its Predisposing factors
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Root surface integrity is essential for periodontal health. The cemental tears (CETs) were more likely to have periodontal bone destruction and the treatment outcome was related to the length and apico-coronal location of the tears. We examined the radiographic CET related to the predisposing factors and the periodontal characteristics. Periapical x-rays taken between 2009 and 2017 were screened and 82 CET teeth among 46 subjects were included. A radio-opaque fragment along the root surface and the related periodontal and periapical bone loss were evaluated radiographically, and the gingival swelling and deep periodontal pocket were examined clinically. The demographic data, clinical, and radiographic findings were recorded and analyzed using the χ2 test. CETs were more prevalent in the incisors of males, aged ≥ 50 years. Single or multiple CETs occurred in the cervical and middle thirds more than the apical third of the roots. CETs presented with deep pockets, abscesses, and fistulae. In cervical CETs, the periodontal space widening and angular bone loss were more prevalent (p < 0.005), regardless of pulp vitality, root filling, and the crown status of the affected tooth and the antagonist. The apical CETs were associated with periapical lesions and loss of pulp vitality (p < 0.001). In conclusion, CETs can mimic periapical or periodontal lesions, which make their early diagnosis difficult. Therefore, CET should be considered as a differential diagnostic entity in isolated sites with rapid periodontal breakdown in elderly patients. Further research is required to examine whether the structural weakness of the cementum would cause multiple tears in the predisposed individuals.
Abstract
Root surface integrity is essential for periodontal health. The cemental tears (CETs) were more likely to have periodontal bone destruction and the treatment outcome was related to the length and apico-coronal location of the tears. We examined the radiographic CET related to the predisposing factors and the periodontal characteristics. Periapical x-rays taken between 2009 and 2017 were screened and 82 CET teeth among 46 subjects were included. A radio-opaque fragment along the root surface and the related periodontal and periapical bone loss were evaluated radiographically, and the gingival swelling and deep periodontal pocket were examined clinically. The demographic data, clinical, and radiographic findings were recorded and analyzed using the χ2 test. CETs were more prevalent in the incisors of males, aged ≥ 50 years. Single or multiple CETs occurred in the cervical and middle thirds more than the apical third of the roots. CETs presented with deep pockets, abscesses, and fistulae. In cervical CETs, the periodontal space widening and angular bone loss were more prevalent (p < 0.005), regardless of pulp vitality, root filling, and the crown status of the affected tooth and the antagonist. The apical CETs were associated with periapical lesions and loss of pulp vitality (p < 0.001). In conclusion, CETs can mimic periapical or periodontal lesions, which make their early diagnosis difficult. Therefore, CET should be considered as a differential diagnostic entity in isolated sites with rapid periodontal breakdown in elderly patients. Further research is required to examine whether the structural weakness of the cementum would cause multiple tears in the predisposed individuals.
참고문헌 (34)
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