Evaluation of Cemental Tear Frequency Using Cone-Beam Computed Tomography: A Retrospective Study

Objective: Cemental tear is a clinical term referring to partial or complete separation of the cementum from the root surface. Unnecessary treatment can be applied due to its low prevalence and difficulty in diagnosis. This study aimed to determine the frequency and distribution of cemental tear using cone-beam computed tomography (CBCT). Materials and Methods: A total of 813 CBCT images were evaluated in this retrospective study. Root fragments that were separated from the root surface on CBCT images were accepted as cemental tear. The frequency of cemental tear, tooth region, tooth type, previous treatment and periapical/periodontal lesions were assessed. A chi-square test was performed to determine the relationship between the categorical variables. Results: The frequency of cemental tear was determined to be 1.85%. Of the patients, 51.3% were males (n=417) and 48.7% (n=396) were females. There was no significant relationship between the frequency of cemental tear and patient age, gender, tooth region, tooth type and previous treatment (p>0.05). In teeth with periapical/periodontal lesions, significantly more frequent cemental tears were observed (p

Semental Ayrılma Sıklığının Konik Işınlı Bilgisayarlı Tomografi ile Değerlendirilmesi: Retrospektif Bir Çalışma

Amaç: Semental ayrılma, sementin kök yüzeyinden tamamen veya kısmen ayrılması anlamına gelen klinik bir terimdir. Düşük prevalansı ve teşhis zorluğu nedeniyle gereksiz tedavi uygulanabilmektedir. Bu çalışmada, semental ayrılma sıklığı ve dağılımının konik ışınlı bilgisayarlı tomografi (KIBT) kullanılarak belirlenmesi hedeflenmiştir. Gereç ve Yöntemler: Toplam 813 KIBT görüntüsü bu retrospektif çalışmada değerlendirildi. KIBT görüntüleri üzerinde, kök yüzeyinden ayrılmış kök parçaları semental ayrılma olarak kabul edildi. Semental ayrılma sıklığı, diş bölgesi, diş tipi, önceden uygulanan tedaviler ve periapikal/ periodontal lezyon varlığı değerlendirildi. Kategorik değişkenler arasındaki ilişkiyi belirlemek için ki-kare testi kullanıldı. Bulgular: Semental ayrılma sıklığı %1,85 olarak belirlendi. Hastaların %51,3’ü erkek (n=417) ve %48,7’si (n=396) kadındı. Semental ayrılma sıklığı ile hasta yaşı, cinsiyeti, diş bölgesi, diş tipi ve önceki tedavi arasında anlamlı bir ilişki saptanmadı (p>0,05). Periapikal/ periodontal lezyonlu dişlerde anlamlı olarak daha fazla semental ayrılma gözlendi (p

PDF

___

1. Haney JM, Leknes KN, Lie T, Selving KA, Wikesjo UM. Cemental tear related to rapid periodontal breakdown: a case report. J Periodontol 1992; 63: 220-4.

2. Leknes KN, Lie T, Selvig KA. Cemental tear: a risk factor in periodontal attachment loss. J Peridontol 1996; 67: 583-8.

3. Lin HJ, Chan CP, Yang CY, Wu CT, Tsai YL, Huang CC, et al. Cemental tear:clinical characteristics and its predisposing factors. J Endod 2011; 37: 611-8.

4. Moule AJ, Kahler B. Diagnosis and management of teeth with vertical root fractures. Aust Dent J 1999; 44: 75-87.

5. Lin HJ, Chang MC, Chang SH, Wu CT, Tsai YL, Chiang CP, et al. Clinical fracture site, morphology and histopathologic characteristics of cemental tear: role in endodontics lesion. J Endod 2012; 38: 1058-62.

6. Tai TF, Chiang CP, Lin CP, Lin CC, Jeng JH. Persistent endodontic lesion due to complex cemento dentinal tears in a maxillary central incisor: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103: e55-60.

7. Camargo PM, Pirih FQ, Wolinsky LE, Lekovic V, Kamrath H, White SN. Clinical repair of an osseous defect associated with a cemental tear: a case report. Int J Periodontics Restorative Dent 2003; 23: 79-85.

8. Jeng PY, Luzi AL, Pitarch RM, Chang MC, Wu YH, Jeng JH. Cemental tear: To know what we have neglected in dental practice. J Formos Med Assoc 2018; 117: 261-7.

9. Lin HJ, Cheng MC, Chang SH, Wu CT, Tsai YL, Huang CC, et al. Treatment outcome of the teeth with cemental tears. J Endod 2014; 40: 1315-20.

10. Keskin C, Güler DH. A retrospective study of the prevalence of cemental tear in sample of the adult population applied Ondokuz Mayıs University Faculty of Dentistry. Meandros Med Dent J 2017; 18: 115-9.

11. Ong TK, Harun N, Lim TW. Cemental tear on maxillary anterior incisors: A description of clinical, radiographic, and histopathological features of two clinical cases. Eur Endod J 2019; 4: 90-5.

12. Watanabe C, Watanabe Y, Miyauchi M, Fujita M, Watanabe Y. Multiple cemental tears. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114: 365-72.

13. Tulkki MJ, Baisden MK, McClanahan SB. Cemental tear: a case report of a rare root fracture. J Endod 2006; 32: 1005-7.

14. Chou J, Rawal YB, O’Neil JR, Tatakis DN. Cementodentinal tear: acase report with 7-year follow-up. J Periodontol 2004; 75: 1708-13.

15. Pilloni A, Nardo F, Rojas MA. Surgical Treatment of a Cemental Tear-Associated Bony Defect Using Hyaluronic Acid and a Resorbable Collagen Membrane: A 2-YearFollow-Up. Clin Adv Periodontics 2019; 9: 64-9.

16. Qari H, Dorn SO, Blum GN, Bouquot JE. The pararadicular radiolucency with vital pulp: Clinicopathologic features of 21 cemental tears. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128: 680-9.