Clinical attachment loss (CAL) is the predominant clinical manifestation and determinant of

periodontal disease Periodontal disease, also known as gum disease, is a set of inflammatory conditions affecting the tissues surrounding the teeth. In its early stage, called gingivitis, the gums become swollen and red and may bleed. It is considered the main caus ...

Anatomy of the attachment

Teeth are attached to the surrounding and supporting alveolar bone by

periodontal ligament The periodontal ligament, commonly abbreviated as the PDL, is a group of specialized connective tissue fibers that essentially attach a tooth to the alveolar bone within which it sits. It inserts into root cementum one side and onto alveolar b ...

(PDL) fibers; these fibers run from the bone into the

cementum Cementum is a specialized calcified substance covering the root of a tooth. The cementum is the part of the periodontium that attaches the teeth to the alveolar bone by anchoring the periodontal ligament.Illustrated Dental Embryology, Histology, a ...

that naturally exists on the entire root surface of teeth. They are also attached to the gingival (gum) tissue that covers the alveolar bone by an attachment apparatus; because this attachment exists superficial to the crest, or height, of the alveolar bone, it is termed the ''supracrestal attachment apparatus''. The supracrestal attachment apparatus is composed of two layers: the coronal

junctional epithelium The junctional epithelium (JE) is that epithelium which lies at, and in health also defines, the base of the gingival sulcus. The probing depth of the gingival sulcus is measured by a calibrated periodontal probe. In a healthy-case scenario, the p ...

and the more

apical Apical means "pertaining to an apex". It may refer to: *Apical ancestor, refers to the last common ancestor of an entire group, such as a species (biology) or a clan (anthropology) *Apical (anatomy), an anatomical term of location for features loc ...

gingival connective tissue fibers.Itoiz, ME; Carranza, FA: The Gingiva. In Newman, MG; Takei, HH; Carranza, FA; editors: ''Carranza’s Clinical Periodontology'', 9th Edition. Philadelphia: W.B. Saunders Company, 2002. pages 26-7. The two layers together form the thickness of the gingival tissue and this dimension is termed the ''

biologic width Crown lengthening is a surgical procedure performed by a dentist, or more frequently a specialist periodontist. There are a number of reasons for considering crown lengthening in a treatment plan. Commonly, the procedure is used to expose a greate ...

''.

Periodontal disease

Plaque-induced periodontal diseases are generally classified destructive or non-destructive. Clinical attachment loss is a sign of destructive (physiologically irreversible) periodontal disease. The term clinical attachment loss is used almost exclusively to refer to connective tissue attachment loss:https://medical-dictionary.thefreedictionary.com/loss+of+attachment

References

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