Clinical Attachment Level

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Documenting the level of attachment helps the clinician determine the amount of periodontal destruction that has occurred and is essential when rendering a diagnosis of periodontitis (loss of connective tissue attachment) 1617 This measurement also provides the clinician with more detailed and accurate information regarding the prognosis of an individual tooth. 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

Documenting Clinical Attachment Loss

Fig. I -1 7. Chart for recording pocket depths. The parallel lines are approximately 2 mm apart. Fol lowing are the notations involved in using the chart:

1. Block out any missing teeth

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. Shade the pocket form on each tooth with a red pencil (between the red and blue lines).

6. Indicate bifurcation or trĀ”furcation involvements with a small red X at the involved area.

7. Record open contacts with vertical parallel lines (II) through the area,

8. Record improper contacts with a wavy red line (V) through the area.

9. Record gingival overhang(s) with a red spur (a) through the area.

10. Outline cavities and faulty restorations of periodontal significance in red.

11. Indicate rotated teeth by outlining in blue to show their actual position.

(Modified slightly from Goldman IIM, Cohen DW: Periodontal therapy, ed 5, Si Louis, 1973, Mosby.)

recession is 0. In a situation in which there is increased periodontal destruction and recession, the loss of attachment measurement equals the probing depth plus the measurement of recession (see Fig. 1-18, B, C). Clinical attachment loss is a measure of periodontal destruction at a site, rather than current disease activity, and it may be considered the diagnostic "gold standard" for periodontitis.19 It should be documented in the initial periodontal examination.") It is an important consideration in the development of the overall diagnosis, treatment plan, and prognosis of the dentition and can be an effective research tool.

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  • Esther
    How to chart clinical attachment level?
    8 years ago
  • keijo
    How do you chart extraction on tooth 16?
    8 years ago
    How to chart periodontal pockets?
    8 years ago
  • Leila
    How to record tooth attachment?
    8 years ago
  • joseph
    How to chart a missing crown of tooth?
    8 years ago
  • Elisa
    How to chart clinical attachment loss?
    8 years ago
  • Asmeret
    How do you measure clinical attachment level in a tooth?
    8 years ago
  • sam
    How to Calculate Attachment Loss?
    7 years ago
  • hildigard
    How to measure clinical attachment loss?
    7 years ago
  • simret
    How to calculate CAL clinical attachment level?
    7 years ago
  • tiia
    How do you calculate attachment loss on teeth?
    7 years ago
  • hamilcar
    What is the difference of clinical attachment level and clinical attachment loss?
    6 years ago
  • Brody
    How do you measure attachment loss in periodontis?
    6 years ago
  • Chiara
    How is clinical attachment loss calculated?
    6 years ago
  • ramona
    How to calculate level of attachment of the tissue to the tooth?
    6 years ago
  • angelica
    What is cleanincal attachment level 3?
    5 years ago
  • steven
    How to measure gingival attachment loss?
    4 years ago
  • samuel amanuel
    What amount of clinical attachment loss makes tooth nonsaveable?
    4 years ago
  • orgulas
    How to chart clinical attachment levels?
    2 years ago
  • Calvin
    Why clincal attachment level is signficant?
    2 years ago
  • abela
    How do we calculate clinical attachment level in gingivak enlargement?
    2 years ago
  • Adelard
    How to measure loss of attachemnt?
    11 months ago
  • ronnie
    What are acceptable measurements for clinical attachment of teeth?
    8 months ago
  • duccio
    How to determine clinical attachment loss?
    8 months ago
  • antonio
    Is there clinical attachment loss on a tooth that supererupts?
    8 months ago
  • farrah
    How to calculate dental recession?
    3 months ago

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