Clinical attachment loss

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

Anatomy of the attachment

Teeth are attached to the surrounding and supporting alveolar bone by periodontal ligament (PDL) fibers; these fibers run from the bone into the cementum 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 and the more apical gingival connective tissue fibers.[1] The two layers together form the thickness of the gingival tissue and this dimension is termed the biologic width.

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.

In gingivitis, inflammation localized to the supracrestal region of the periodontium leads to ulceration of the junctional epithelium.[2] Although this is technically a loss of clinical attachment (because, in health, the epithelium attaches to the surface of the tooth), the term clinical attachment loss is used almost exclusively to refer to connective tissue attachment loss:

Sites with periodontitis exhibit clinical signs of gingival inflammation and loss of connective tissue attachment. Connective tissue attachment loss refers to the pathological detachment of collagen fibers from cemental surface with the concomitant apical migration of the junctional or pocket epithelium onto the root surface.[2]


  1. ^ 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.
  2. ^ a b Armitage, GC. Clinical evaluation of periodontal disease. Perio 2000 1995;7:39-53

Wikimedia Foundation. 2010.

Look at other dictionaries:

  • Attachment in children — is a theory of attachment between children and their caregivers specifically addressing the behaviors and emotions that children direct toward familiar adults. It is primarily an evolutionary and ethological theory postulating that infants seek… …   Wikipedia

  • Attachment disorder — is a broad term intended to describe disorders of mood, behavior, and social relationships arising from a failure to form normal attachments to primary care giving figures in early childhood, resulting in problematic social expectations and… …   Wikipedia

  • Attachment in adults — deals with the theory of attachment in adult romantic relationships.Attachment theory was extended to adult romantic relationships in the late 1980s. Four styles of attachment have been identified in adults: secure, anxious preoccupied,… …   Wikipedia

  • Attachment theory — …   Wikipedia

  • Attachment therapy — This article is about a specific form of therapy commonly known as attachment therapy . For therapies based on Bowlby s attachment theory, see Attachment based therapy (children). Attachment therapy is the most commonly used term for a… …   Wikipedia

  • History of attachment theory — Attachment theory, originating in the work of John Bowlby, is a psychological, evolutionary and ethological theory that provides a descriptive and explanatory framework for understanding interpersonal relationships between human beings. In order… …   Wikipedia

  • Reactive attachment disorder — DiseaseDisorder infobox Name = Reactive attachment disorder |thumb|190px Caption = Children need sensitive and responsive caregivers to develop secure attachments. DiseasesDB = ICD10 = ICD10|F|94|1|f|90, ICD10|F|94|2|f|90 ICD9 = 313.89 ICDO =… …   Wikipedia

  • Chronic periodontitis — is a common disease of the oral cavity consisting of chronic inflammation of the periodontal tissues that is caused by accumulation of profuse amounts of dental plaque. Chronic periodontitis Classification and external resources ICD 10 K05.3 ICD… …   Wikipedia

  • Occlusal trauma — Not to be confused with Bluetooth. Occlusal trauma is a dental term that refers to the damage incurred when teeth are left in traumatic occlusion without proper treatment.[1] When the maxillary and mandibular dental arches approach each together …   Wikipedia

  • Gingivitis — Classification and external resources Severe gingivitis before (top) and after (bottom) a thorough mechanical debridement of the teeth and adjacent gum tissues. ICD 10 …   Wikipedia

Share the article and excerpts

Direct link
Do a right-click on the link above
and select “Copy Link”

We are using cookies for the best presentation of our site. Continuing to use this site, you agree with this.