Cemental tear on maxillary first molars related to traumatic occlusion: a case report

A cemental tear represents a unique type of root surface fracture associated with the destruction of periodontal and periapical tissues. This report presents a case of cemental tears in maxillary first molars. Based on clinical and radiographic evidence, a tentative diagnosis of chronic periapical periodontitis (cemental tear) was made for both the left and right maxillary first molars. After careful consideration, the patient postponed treatment of the asymptomatic right maxillary first molar. The left maxillary first molar due to severe alveolar bone loss, was extracted seven days later. Early diagnosis and complete removal of the cemental tear are key factors in successful treatment. Therefore, cemental tears should be considered in all teeth, including molars. Clinicians should remain vigilant when examining patients presenting with potential causative factors such as localized deep periodontal pockets, loss of attachment, or signs of occlusal trauma.