Treatment of Periodontal Destruction Associated With a Cemental Tear Using Minimally Invasive Surgery

BACKGROUND: A patient presented with moderate probing depth, pain on occlusal contact, and a fistula on a mandibular bicuspid. The probing depth increased 2 mm over a 3-month period despite relief of the occlusal trauma and resolution of the fistula. A radiograph showed an apparent separation of the cementum in the area of the pocket. METHODS: The lesion was treated using a minimally invasive surgical approach to place a bone graft. RESULTS: The probing depth was reduced to 2 mm with less than 1 mm of increased recession. A histologic examination of the damaged calcified tissue confirmed that it was cementum. CONCLUSIONS: The increasing probing depth associated with a cemental tear seems to indicate that this phenomenon contributed to loss of attachment and bone. Removal of the detached cementum in combination with bone grafting using a minimally invasive surgical approach appears to have successfully corrected the periodontal destruction.