In this episode of Endo Voices, Dr. Marcus D. Johnson sits down with Dr. Pierre Wohlgemuth for a thoughtful and collegial examination of two defining challenges in contemporary endodontics: the elusive cemental tear and the disciplined art of soft tissue management in surgical care.
Cemental tears—seldom discussed yet likely underdiagnosed—often masquerade as endodontic or periodontal pathology. With a limited but growing body of evidence, accurate identification demands clinical vigilance. Key red flags include vital teeth presenting with periapical radiolucencies and persistent disease following technically adequate root canal therapy. The discussion explores the roles of occlusal trauma, CBCT interpretation, and histologic confirmation, reinforcing the importance of expanding the differential diagnosis before defaulting to retreatment or extraction. Decisions surrounding tooth preservation versus implant placement are framed not as reflexive, but as biologically and prognostically driven.
A central theme resonates throughout: clinicians do not rise to the level of their intentions—they fall to the level of their training.
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