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KMID : 0362720160540050365
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Journal of the Korean Dental Association
2016 Volume.54 No. 5 p.365 ~ p.373
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Treatment of cemental tear associated with periapical lesion using regenerative surgery; A case report
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강효진:Kang Hyo-Jin
정겨운:Jung Gyu-Un/방은경:Pang Eun-Kyoung
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Abstract
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Purpose: Cemental tear is a specific type of root surface fracture characterized by a complete separation of a cemental fragment along the cementodentinal junction or a partial split within the cementum along an incremental line. It is suggested to be a factor for periodontal or periapical tissue destruction. The aim of this study is to present a diagnosis and treatment of cemental tear associated with periapical lesion with root canal treatment and regenerative periodontal surgery.
Treatments: A 60-year-old male who had a history of sports trauma on the mandibular right central incisor about 10 years ago presented with apical cemental tear. Clinical examination showed a slightly dark yellowish discoloration and sinus tract that was located on the apical labial mucosa. The mobility and percussion were also assessed on the diseased tooth and recorded as Miller°Øs Class II and tenderness to percussion. The probing depth was within the normal limit (<3 mm). Radiographic examination revealed a radiolucent lesion at the apical area and extended to distal aspect of the tooth along the fragment of cemental tear. After root canal treatment, periapical surgery was performed. The bony defect was exposed and then the detached root fragment was removed. Apical root resection and retrograde filling with Mineral Trioxide Aggregate (MTA) were accomplished and the bony defect was filled with deproteinized bovine bone mineral (DBBM) and covered with biodegradable collagen membrane.
Results: After 9-month follow-up, healing of the mandibular right central incisor was uneventful and no swelling, purulence or pain was revealed in the associated area. Probing pocket depth was favorably stable, and the tooth mobility was decreased to the Miller’s Class I.
Conclusions: Apical cemental tear associated periapical lesion could be successfully treated with removal of the detached
cementum in combination with apical surgery and GTR procedure.
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KEYWORD
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cemental tear, guided tissue regeneration, periapical disease
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