Hsueh-Jen Lin1, Mei-Chi Chang2, Shu-Hui Chang3, Chen-Tsai Wu4, Yi-Ling Tsai5, Chih-Chia Huang6, Shu-Fang Chang7, Ya-Wen Cheng5, Chiu-Po Chan8, Jiiang-Huei Jeng9. 1. Dental Department, Show Chwan Memorial Hospital, Changhua, Taiwan; Graduate Institute of Clinical Dentistry and Department of Dentistry, School of Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan. 2. Biomedical Science Team, Chang Gung University of Science and Technology, Kwei-Shan, Taoyuan, Taiwan. 3. Laboratory of Biostatistics, College of Public Health, National Taiwan University, Taipei, Taiwan. 4. Dental Department, Show Chwan Memorial Hospital, Changhua, Taiwan. 5. Graduate Institute of Clinical Dentistry and Department of Dentistry, School of Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan. 6. Department of Dentistry, Cardinal Tien Hospital, New Taipei City, Taiwan. 7. Department of Dentistry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan. 8. Department of Periodontics, Chang Gung Memorial Hospital and Chang Gung University, Taipei, Taiwan. Electronic address: carol@adm.cgmh.org.tw. 9. Graduate Institute of Clinical Dentistry and Department of Dentistry, School of Dentistry, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan. Electronic address: jhjeng@ntu.edu.tw.
Abstract
INTRODUCTION: A cemental tear is a special type of surface root fracture noted in combination with periodontal and/or periapical bony destruction. We hypothesized that clinical characteristics and treatment techniques may affect the prognosis of teeth with cemental tears. METHODS: Treatment outcome for the teeth with a cemental tear was assessed in a multicenter cemental tear study project. Of the 71 teeth with cemental tears, 38 teeth (53.5%) were extracted. The remaining 33 teeth (46.5%) were examined for a treatment outcome of healed, questionable, or failed. RESULTS: Outcome assessment found that 51.5% (17/33), 42.4% (14/33), and 6.1% (2/33) of teeth were classified as healed, questionable, and failed, respectively. Additive bivariate analysis indicated a significant difference between treatment outcome and the length (P = .01) and apicocoronal location (P = .02) of the separated root fragments. Logistic regression analysis found that treatment technique and apicocoronal location of cemental tears may affect the treatment outcome. The percentage of healed cemental tear cases located in the apical, middle, and cervical third of roots was 11.1%, 66.7%, and 60.0%, respectively. By surgical management, 57.7% of cemental tears were healed, whereas only 28.6% cases were healed after nonsurgical treatment. CONCLUSIONS: Most teeth with cemental tears can be retained to function by nonsurgical and surgical periodontal and endodontic treatment. Clinical diagnosis and treatment of cemental tears should also consider the apicocoronal location and the type of treatment technique to improve outcomes.
INTRODUCTION: A cemental tear is a special type of surface root fracture noted in combination with periodontal and/or periapical bony destruction. We hypothesized that clinical characteristics and treatment techniques may affect the prognosis of teeth with cemental tears. METHODS: Treatment outcome for the teeth with a cemental tear was assessed in a multicenter cemental tear study project. Of the 71 teeth with cemental tears, 38 teeth (53.5%) were extracted. The remaining 33 teeth (46.5%) were examined for a treatment outcome of healed, questionable, or failed. RESULTS: Outcome assessment found that 51.5% (17/33), 42.4% (14/33), and 6.1% (2/33) of teeth were classified as healed, questionable, and failed, respectively. Additive bivariate analysis indicated a significant difference between treatment outcome and the length (P = .01) and apicocoronal location (P = .02) of the separated root fragments. Logistic regression analysis found that treatment technique and apicocoronal location of cemental tears may affect the treatment outcome. The percentage of healed cemental tear cases located in the apical, middle, and cervical third of roots was 11.1%, 66.7%, and 60.0%, respectively. By surgical management, 57.7% of cemental tears were healed, whereas only 28.6% cases were healed after nonsurgical treatment. CONCLUSIONS: Most teeth with cemental tears can be retained to function by nonsurgical and surgical periodontal and endodontic treatment. Clinical diagnosis and treatment of cemental tears should also consider the apicocoronal location and the type of treatment technique to improve outcomes.