Cemental tears: theoretical basis, etiology, treatments and outcome

ABSTRACT Cemental tears are characterized by the partial or total detachment of cementum along the dentinocemental junction or incremental lines within the cementum, possibly involving the adjacent radicular dentin. Although this condition has been documented in some studies, its pathogenesis remains poorly understood. This integrative review aimed to analyze the etiology, treatments, and outcome of cemental tears based on studies published between 2019 and 2024. The findings indicate that, despite advancements in imaging techniques such as cone-beam computed tomography, early diagnosis of cemental tears remains challenging. Identification of this condition often occurs late when significant periodontal compromise is already present. Reviewed studies suggest that predisposing factors, such as the affected tooth type, history of trauma, and advanced age, may influence the onset of the pathology. However, the scarcity of research and the variability of therapeutic protocols hinder the standardization of clinical approaches. Treatment options range from conservative methods, such as cemental fragment removal and guided tissue regeneration, to invasive interventions, such as tooth extraction in cases of severe periodontal damage. The findings of this review highlight the urgent need for further clinical studies to enhance the understanding of cemental tears pathophysiology and establish more effective therapeutic guidelines.