Diagnosis and management of cemental tear: a case report

A 32-year-old man complained of swelling after an extraction in the vicinity of the left maxillary premolars. The occlusal surface of the first premolar showed no caries while the second premolar was covered with a crown. Radiographic examination revealed a thin radiolucent defect subgingivally below the cementodentinal junction on the distal aspect. During a review of medical history, the patient presented an extracted fragment that was sent for histopathological examination. A root canal was performed and the defect was closed with mineral trioxide aggregate followed by glass ionomer cement. Histopathology revealed the fragment to be a cemental tear, a condition associated typically with old age, trauma, and traumatic occlusion. Dentists should be aware of this rare entity as a differential diagnosis in cases involving noncarious odontogenic pain.