Expert consensus on the diagnosis and treatment of cemental tear
Abstract Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, a...
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Nature Publishing Group
2025-08-01
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| Series: | International Journal of Oral Science |
| Online Access: | https://doi.org/10.1038/s41368-025-00381-9 |
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| author | Ye Liang Hongrui Liu Chengjia Xie Yang Yu Jinlong Shao Chunxu Lv Wenyan Kang Fuhua Yan Yaping Pan Faming Chen Yan Xu Zuomin Wang Yao Sun Ang Li Lili Chen Qingxian Luan Chuanjiang Zhao Zhengguo Cao Yi Liu Jiang Sun Zhongchen Song Lei Zhao Li Lin Peihui Ding Weilian Sun Jun Wang Jiang Lin Guangxun Zhu Qi Zhang Lijun Luo Jiayin Deng Yihuai Pan Jin Zhao Aimei Song Hongmei Guo Jin Zhang Pingping Cui Song Ge Rui Zhang Xiuyun Ren Shengbin Huang Xi Wei Lihong Qiu Jing Deng Keqing Pan Dandan Ma Hongyu Zhao Dong Chen Liangjun Zhong Gang Ding Wu Chen Quanchen Xu Xiaoyu Sun Lingqian Du Ling Li Yijia Wang Xiaoyuan Li Qiang Chen Hui Wang Zheng Zhang Mengmeng Liu Chengfei Zhang Xuedong Zhou Shaohua Ge |
| author_facet | Ye Liang Hongrui Liu Chengjia Xie Yang Yu Jinlong Shao Chunxu Lv Wenyan Kang Fuhua Yan Yaping Pan Faming Chen Yan Xu Zuomin Wang Yao Sun Ang Li Lili Chen Qingxian Luan Chuanjiang Zhao Zhengguo Cao Yi Liu Jiang Sun Zhongchen Song Lei Zhao Li Lin Peihui Ding Weilian Sun Jun Wang Jiang Lin Guangxun Zhu Qi Zhang Lijun Luo Jiayin Deng Yihuai Pan Jin Zhao Aimei Song Hongmei Guo Jin Zhang Pingping Cui Song Ge Rui Zhang Xiuyun Ren Shengbin Huang Xi Wei Lihong Qiu Jing Deng Keqing Pan Dandan Ma Hongyu Zhao Dong Chen Liangjun Zhong Gang Ding Wu Chen Quanchen Xu Xiaoyu Sun Lingqian Du Ling Li Yijia Wang Xiaoyuan Li Qiang Chen Hui Wang Zheng Zhang Mengmeng Liu Chengfei Zhang Xuedong Zhou Shaohua Ge |
| author_sort | Ye Liang |
| collection | DOAJ |
| description | Abstract Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear. |
| format | Article |
| id | doaj-art-22cec5e7d07442128447915033e222ee |
| institution | Kabale University |
| issn | 2049-3169 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Nature Publishing Group |
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| series | International Journal of Oral Science |
| spelling | doaj-art-22cec5e7d07442128447915033e222ee2025-08-24T11:11:16ZengNature Publishing GroupInternational Journal of Oral Science2049-31692025-08-0117111010.1038/s41368-025-00381-9Expert consensus on the diagnosis and treatment of cemental tearYe Liang0Hongrui Liu1Chengjia Xie2Yang Yu3Jinlong Shao4Chunxu Lv5Wenyan Kang6Fuhua Yan7Yaping Pan8Faming Chen9Yan Xu10Zuomin Wang11Yao Sun12Ang Li13Lili Chen14Qingxian Luan15Chuanjiang Zhao16Zhengguo Cao17Yi Liu18Jiang Sun19Zhongchen Song20Lei Zhao21Li Lin22Peihui Ding23Weilian Sun24Jun Wang25Jiang Lin26Guangxun Zhu27Qi Zhang28Lijun Luo29Jiayin Deng30Yihuai Pan31Jin Zhao32Aimei Song33Hongmei Guo34Jin Zhang35Pingping Cui36Song Ge37Rui Zhang38Xiuyun Ren39Shengbin Huang40Xi Wei41Lihong Qiu42Jing Deng43Keqing Pan44Dandan Ma45Hongyu Zhao46Dong Chen47Liangjun Zhong48Gang Ding49Wu Chen50Quanchen Xu51Xiaoyu Sun52Lingqian Du53Ling Li54Yijia Wang55Xiaoyuan Li56Qiang Chen57Hui Wang58Zheng Zhang59Mengmeng Liu60Chengfei Zhang61Xuedong Zhou62Shaohua Ge63Department of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral DiseasesDepartment of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral DiseasesDepartment of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral DiseasesDepartment of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral DiseasesDepartment of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral DiseasesDepartment of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral DiseasesDepartment of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral DiseasesDepartment of Periodontology, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Institute of Stomatology, Nanjing UniversityDepartment of Periodontics, School and Hospital of Stomatology, China Medical UniversityState Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, The Fourth Military Medical UniversityDepartment of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University, Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical UniversityDepartment of Stomatology, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Implantology, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and RegenerationKey Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong UniversityDepartment of Oral Medicine, The Second Affiliated Hospital, School of Medicine, Zhejiang UniversityDepartment of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of EngineeringHospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Sun Yat-sen UniversityState Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University; Department of Periodontology, School & Hospital of Stomatology, Wuhan UniversityLaboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical UniversityDalian Stomatological HospitalDepartment of Periodontology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of StomatologyState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Periodontics, West China Hospital of Stomatology, Sichuan UniversityDepartment of Periodontics, School and Hospital of Stomatology, China Medical UniversityStomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang UniversityDepartment of Oral Medicine, The Second Affiliated Hospital, School of Medicine, Zhejiang UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Periodontics, West China Hospital of Stomatology, Sichuan UniversityDepartment of Stomatology, Beijing TongRen Hospital, Capital Medical UniversityDepartment of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Endodontics, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and RegenerationDepartment of Periodontics, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and RegenerationSchool and Hospital of Stomatology, Tianjin Medical UniversityDepartment of Endodontics, School and Hospital of Stomatology, Wenzhou Medical UniversityDepartment of Endodontics, First Affiliated Hospital of Xinjiang Medical University, and College of Stomatology of Xinjiang Medical UniversityDepartment of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral DiseasesDepartment of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral DiseasesDepartment of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Provincial Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral DiseasesDepartment of Endodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Provincial Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral DiseasesSchool and Hospital of Stomatology, Zunyi Medical UniversitySchool and Hospital of Stomatology, Zunyi Medical UniversityShanxi Medical University School and Hospital of Stomatology, Shanxi Province Key Laboratory of Oral Diseases Prevention and New MaterialsDepartment of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical UniversityDepartment of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of StomatologyDepartment of Endodontics, School and Hospital of Stomatology, China Medical University; Liaoning Provincial Key Laboratory of Oral DiseasesDepartment of Stomatology, The Affiliated Hospital of Qingdao UniversityDepartment of Stomatology, The Affiliated Hospital of Qingdao UniversityDepartment of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical UniversityDepartment of Stomatology, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Stomatology, The First Affiliated Hospital of Zhengzhou UniversityStomatology Center, Affiliated Hospital of Hangzhou Normal UniversitySchool of Stomatology, Shandong Second Medical UniversityDepartment of Periodontology, The Affiliated Stomatological Hospital of Nanjing Medical University, Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical UniversityDepartment of Stomatology, The Affiliated Hospital of Qingdao UniversityKey Laboratory of Oral Diseases Research of Anhui Province, College & Hospital of Stomatology, Anhui Medical UniversityThe Second Hospital of Shandong UniversityDepartment of Periodontology, Linyi People’s Hospital, Shandong Second Medical UniversityLaboratory of Tissue Regeneration and Immunology and Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical UniversityDepartment of Stomatology, The Fifth People’s Hospital of JinanSuzhou Stomatological HospitalSuzhou Stomatological HospitalTianjin Stomatological Hospital, School of Medicine, Nankai universityDepartment of Stomatology, Qilu Hospital of Shandong University (Qingdao), Cheeloo College of Medicine, Shandong UniversityRestorative Dental Sciences, Faculty of Dentistry, The University of Hong KongState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan UniversityDepartment of Periodontology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral DiseasesAbstract Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.https://doi.org/10.1038/s41368-025-00381-9 |
| spellingShingle | Ye Liang Hongrui Liu Chengjia Xie Yang Yu Jinlong Shao Chunxu Lv Wenyan Kang Fuhua Yan Yaping Pan Faming Chen Yan Xu Zuomin Wang Yao Sun Ang Li Lili Chen Qingxian Luan Chuanjiang Zhao Zhengguo Cao Yi Liu Jiang Sun Zhongchen Song Lei Zhao Li Lin Peihui Ding Weilian Sun Jun Wang Jiang Lin Guangxun Zhu Qi Zhang Lijun Luo Jiayin Deng Yihuai Pan Jin Zhao Aimei Song Hongmei Guo Jin Zhang Pingping Cui Song Ge Rui Zhang Xiuyun Ren Shengbin Huang Xi Wei Lihong Qiu Jing Deng Keqing Pan Dandan Ma Hongyu Zhao Dong Chen Liangjun Zhong Gang Ding Wu Chen Quanchen Xu Xiaoyu Sun Lingqian Du Ling Li Yijia Wang Xiaoyuan Li Qiang Chen Hui Wang Zheng Zhang Mengmeng Liu Chengfei Zhang Xuedong Zhou Shaohua Ge Expert consensus on the diagnosis and treatment of cemental tear International Journal of Oral Science |
| title | Expert consensus on the diagnosis and treatment of cemental tear |
| title_full | Expert consensus on the diagnosis and treatment of cemental tear |
| title_fullStr | Expert consensus on the diagnosis and treatment of cemental tear |
| title_full_unstemmed | Expert consensus on the diagnosis and treatment of cemental tear |
| title_short | Expert consensus on the diagnosis and treatment of cemental tear |
| title_sort | expert consensus on the diagnosis and treatment of cemental tear |
| url | https://doi.org/10.1038/s41368-025-00381-9 |
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