{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:11:59Z","timestamp":1791389519752,"version":"4.3.3"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Adv Periodontics"],"published-print":{"date-parts":[[2026,9]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Cemental tear, representing separation of cementum from the root surface, is a rare but challenging condition often mimicking vertical root fracture or endodontic\u2013periodontal lesions. Despite advances in regenerative therapy, a predictable treatment protocol for cemental tears with non\u2010contained bone defects remains lacking. Minimally invasive regenerative surgical techniques, such as the entire papilla preservation technique (EPPT) and connective tissue graft (CTG) wall technique, may optimize wound stability and enhance clinical outcomes when combined with biologic agents.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A 73\u2010year\u2010old male patient presenting with gingival swelling and suppuration in #8 was diagnosed with a two\u2010wall bone defect associated with a cemental tear (Class 3\/Stage B) using cone\u2010beam computed tomography (CBCT). Regenerative therapy was performed using recombinant human fibroblast growth factor\u20102 (rhFGF\u20102), carbonate apatite (CO\n 3<\/jats:sub>\n Ap), and a CTG applied via the EPPT. Clinical parameters and radiographic findings were evaluated at baseline and 1, 3, 6, and 12 months postoperatively.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Healing progressed without postoperative complications such as gingival recession or graft exposure. The probing pocket depth was reduced from 10 to \u22643\u00a0mm, and clinical attachment gain of 7\u00a0mm was achieved at 12 months. CBCT demonstrated complete radiographic bone fill and reformation of the proximal and labial bone walls.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Combination regenerative therapy using rhFGF\u20102, CO\n 3<\/jats:sub>\n Ap, and CTG with the EPPT achieved stable soft and hard tissue regeneration in an elderly patient with a cemental tear\u2013associated two\u2010wall bone defect. This multidisciplinary, minimally invasive approach shows promise for managing complex non\u2010contained intrabony defects while maintaining gingival esthetics.\n <\/jats:p>\n <\/jats:sec>\n \n Key points<\/jats:title>\n \n \n \n \n A multidisciplinary regenerative approach combining rhFGF\u20102, CO\n 3<\/jats:sub>\n Ap, and CTG with EPPT resulted in favorable clinical and radiographic outcomes for a cemental tear\u2013associated two\u2010wall bone defect.\n <\/jats:p>\n <\/jats:list-item>\n \n The CTG wall technique functioned as a protective barrier, minimized gingival recession, and promoted soft tissue stability.<\/jats:p>\n <\/jats:list-item>\n \n Cone\u2010beam computed tomography aided in the accurate diagnosis of cemental tear morphology and postoperative evaluation of bone regeneration.<\/jats:p>\n <\/jats:list-item>\n \n This case underscores the importance of flap design and biologic integration in achieving optimal periodontal and esthetic results.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Plain language summary<\/jats:title>\n \n This case report describes a new treatment method for repairing bone loss around a tooth caused by a \u201ccemental tear,\u201d a type of root surface damage that can lead to gum swelling and bone destruction. A 73\u2010year\u2010old male patient was treated with a combination of a growth factor (rhFGF\u20102), a synthetic bone substitute (CO\n 3<\/jats:sub>\n Ap), and a small piece of gum tissue (CTG) using a minimally invasive surgical technique that preserves the entire gum papilla. Over 12 months, the treatment resulted in significant healing of both bone and gum tissues without recession. This approach may offer a reliable option for saving teeth with similar severe bone defects.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/cap.70048","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T09:47:46Z","timestamp":1771494466000},"page":"618-628","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["EPPT\u2013CTG regeneration using rhFGF\u20102\/CO\n 3<\/sub>\n Ap for cemental tear defects: A case report"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6896-1404","authenticated-orcid":false,"given":"Takayoshi","family":"Nagahara","sequence":"first","affiliation":[{"name":"Department of Dentistry Nippon Kokan Fukuyama Hospital Fukuyama Japan"},{"name":"Department of Periodontal Medicine Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima 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