<h3>BACKGROUND</h3> Cemental tears are a form of root surface fracture caused by partial or total separation of cementum from the root surface.<sup>1-4</sup> Common clinical findings include deep periodontal pockets, gingival swelling, and pain. Owing to the overlapping clinical signs and symptoms with apical periodontitis, vertical root fracture, and periodontitis, cemental tears are often misdiagnosed and inappropriately treated. Their true prevalence remains unknown; however, many suspect that they occur more commonly than previously thought. <h3>CASE REPORT</h3> We report 3 patients examined at the University of Toronto. Two patients presented with draining fistulas and deep probing depths, and the third patient presented with a buccal vestibular swelling. Imaging examinations revealed a well-defined, linear, radiopaque/high-attenuation focus partially attached to or within close proximity to the adjacent root surface. The radiologic differential interpretation of the radiopaque/high-attenuation focus include dystrophic calcification, displaced bone or root fragments, or a cemental tear.<sup>1-5</sup> Owing to the linear nature of the radiopaque/high-attenuation entities and their positions parallel to the adjacent root surfaces, cemental tears were suspected. There was visual confirmation of sloughing cementum in 1 of the reported cases. <h3>DISCUSSION/CONCLUSIONS</h3> Cemental tears tend to be underreported, and this may be due to diagnostic difficulties. Definitive treatment via complete removal of the torn cemental fragment allows for successful healing and prolonged retention of the tooth. A review of the literature is also provided that summarizes the common radiographic presentations of histologically or visually verified cases of cemental tears.