Cemental tear: An unusual cause for persisting endodontic periodontal lesion

Cemental tear represents a rare form of root surface fracture which makes teeth prone to periodontal breakdown. The diagnosis of cemental tear becomes a challenge as it is usually neglected or misdiagnosed and is also underreported in the literature. Correct diagnosis and early treatment of cemental tear can prevent further periodontal breakdown and may preserve the affected tooth for a longer duration. This case presents the diagnosis, treatment, and an analysis of a right maxillary lateral incisor with an improper endodontic treatment coupled with a cemental tear. Despite surgical removal, the cemental tear led to the development of an endodontic periodontal lesion. This article intends to help recognize early signs and symptoms of cemental tear and establish timely diagnosis. It determines that if the periodontal destruction caused by cemental tears is diagnosed and treated early, it may be possible to prevent further periodontal breakdown and preserve the tooth for a longer period.