how do you determine clinical attachment level

How do you calculate clinical attachment level?

1. When recession of the gingival margin is present, the CAL is calculated by adding the probing depth to the gingival margin level.
2. When the gingival margin is coronal to the CEJ, the CAL is calculated by subtracting the gingival margin level from the probing depth.

Full Answer

What is normal clinical attachment level?

1) Oral examination The mean value of clinical attachment loss was obtained and divided into 4 groups: a clinical attachment of <1 mm (normal group), a clinical attachment of 1 - 3 mm (mild group), a clinical attachment of 3 - 5 mm (moderate group) and a clinical attachment of ≥5 mm (severe group).

What is the attachment level?

The clinical attachment level (CAL) and radiographically assessed bone levels are used to assess the loss of periodontal tissue support in periodontitis, a chronic, multifactorial inflammatory disease of the periodontium.

How is attachment loss measured?

Clinical attachment level (or loss, CAL) is a more accurate indicator of the periodontal support around a tooth than probing depth alone. CAL is measured from a fixed point on the tooth that does not change, the CEJ.

How do you calculate pocket depth?

In a healthy mouth, a pocket can be anywhere from 1-3 millimeters deep. To measure a pocket we use a periodontal probe. The probe allows us to measure in millimeters from the top of the pocket to the bottom of the pocket. The bottom of the pocket is the area where the tissue is connected through ligaments to the root.

Does clinical attachment loss mean bone loss?

In general, significant attachment loss preceded bone loss by 6 to 8 months. At 4 mm, attachment loss was found to predict subsequent bone loss with a true positive ratio of 60% and a false positive ratio of 5%, indicating a high degree of predictive discrimination.

What does clinical attachment loss mean?

Clinical attachment loss which is also known as CAL, is the presence of periodontal disease. Periodontal disease, or gum disease, is a set of inflammatory conditions which affect the tissues that surround the teeth. In the early stage, the condition is called gingivitis.

How would you record attachment levels if the CEJ is absent?

If the CEJ is not present due to a restoration, or difficult to determine, it can be recorded from margin of a restoration or a stent and the recording thus made is referred as Relative attachment level (RAL).

Is clinical attachment loss the same as recession?

General Approach. Periodontitis is the inflammatory process initiated by the presence of biofilm, with destruction of the tooth's supporting structures, including bone. Clinical attachment loss is apparent with pocketing and with no gingival recession, or recession with no pocketing, or both pocketing and recession.

How is bone loss in teeth calculated?

The percentage of periodontal bone loss (PBL) was measured by two methods (area and distance) in teeth with (LIG) and without ligature (UNLIG) for the palatal and buccal maxilla, and the lingual mandible. PBL was determined using the following equation: PBL= (LIG – UNLIG) x100/LIG.

What is the most reliable method of measuring pocket depth?

Conclusion: PA-on automated periodontal probe offers an efficient method of detecting periodontal pockets depth in less time and providing more accurate measures. PA-on has an additional advantage of immediate electronic store and analysis of measurements, along with other periodontal health indicators.

What is the normal probing depth?

Probing depth (referred to as pocket depth if periodontal disease is present) is the distance from the gingival margin to the apical portion of the gingival sulcus. Probing depths in healthy gingival sulci normally range from 1 to 3 mm. A depth of greater than 3 mm is a possible cause for concern.

Is pocket depth the same as probing depth?

Conceptually, pocket examination is intended to reflect the distance from the bottom of the pocket to the gingi- val margin. In clinical reality, a surrogate is used. It is called probing depth and assesses the distance from the probe tip to the gingival margin.

What are the 4 stages of attachment?

Examples: The Types, Styles, and Stages (Secure, Avoidant, Ambivalent, and Disorganized)

What are 5 attachments?

The Five Levels of Attachment cites a collection of Ruiz Sr. quotes, Don Quixote passages, and personal adventures of the author himself to illustrate his points and help readers relate. The five levels addressed are: Authentic Self, Preference, Identity, Internalization, and Fanatacism.

What is meant by attachment in psychology?

attachment theory, in developmental psychology, the theory that humans are born with a need to form a close emotional bond with a caregiver and that such a bond will develop during the first six months of a child's life if the caregiver is appropriately responsive.

What is the attachment in the making phase?

The next phase is called attachment-in-the-making. During this phase, infants show a preference for familiar people. They are more interactive with familiar people and are more easily comforted by them. But infants are still happy to spend some time with strangers.

How to determine the level of attachment?

The clinical attachment level (CAL or AL) is determined by measuring the distance between the apical extent of the probing depth and a fixed reference point on the tooth, most commonly either the apical extent of a restoration and/or the cemen-toenamel junction (CEJ). This measurement can be documented on modified periodontal charts (Fig. 1-18) and incorporated with the standard periodontal documentation (see Fig. 1-17) to complete the clinical periodontal examination. When the free margin of the gingiva is located on the clinical crown and the level of the epithelial attachment is at the CEJ, there is no loss of attachment, and recession is noted as a negative number. When the level of the epithelial attachment is on root structure and the free margin of the gingiva is at the CEJ, the attachment loss equals the probing depth, and the

How to record pocket depths?

2. Draw a red X through the crown of any tooth that is to be extracted. 3. Record the gingival level with a continuous blue line. 4. Record pocket depths with a red line interrupted at the proximal surfaces of each tooth. 5.

Why are no calculations required when the gingival margin is level to the CEJ?

There are no calculations required when the gingival margin is level to the CEJ because the probing depth and the CAL are equal.

How to calculate CAL?

When the gingival margin is coronal to the CEJ, the CAL is calculated by SUBTRACTING the gingival margin level from the probing depths.

How much bone is apical to CEJ?

A healthy bone level is approximately 2mm apical to the CEJ.

Which margin covers a portion of the crown?

The gingival margin is significantly coronal to the CEJ and covers a portion of the tooth crown.