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Clinical attachment loss (CAL) is the predominant clinical manifestation and determinant of periodontal disease.
| | This article needs additional citations for verification .(January 2012) |
Clinical attachment loss (CAL) is the predominant clinical manifestation and determinant of periodontal disease.
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 .
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
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]
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.
The gums or gingiva consist of the mucosal tissue that lies over the mandible and maxilla inside the mouth. Gum health and disease can have an effect on general health.
In dental anatomy, the cementoenamel junction (CEJ) is the location where the enamel, which covers the anatomical crown of a tooth, and the cementum, which covers the anatomical root of a tooth, meet. Informally it is known as the neck of the tooth. The border created by these two dental tissues has much significance as it is usually the location where the gingiva (gums) attaches to a healthy tooth by fibers called the gingival fibers.
The periodontal ligament, commonly abbreviated as the PDL, are a group of specialized connective tissue fibers that essentially attach a tooth to the alveolar bone within which they sit. It inserts into root cementum on one side and onto alveolar bone on the other.
Periodontology or periodontics is the specialty of dentistry that studies supporting structures of teeth, as well as diseases and conditions that affect them. The supporting tissues are known as the periodontium, which includes the gingiva (gums), alveolar bone, cementum, and the periodontal ligament. A periodontist is a dentist that specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants.
In dental anatomy, the gingival sulcus is an area of potential space between a tooth and the surrounding gingival tissue and is lined by sulcular epithelium. The depth of the sulcus is bounded by two entities: apically by the gingival fibers of the connective tissue attachment and coronally by the free gingival margin. A healthy sulcular depth is three millimeters or less, which is readily self-cleansable with a properly used toothbrush or the supplemental use of other oral hygiene aids.
Crown lengthening is a surgical procedure performed by a dentist, or more frequently a periodontist, where more tooth is exposed by removing some of the gingival margin (gum) and supporting bone. Crown lengthening can also be achieved orthodontically by extruding the tooth.
In dental anatomy, the gingival and periodontal pockets are dental terms indicating the presence of an abnormal depth of the gingival sulcus near the point at which the gingival (gum) tissue contacts the tooth.
Crown-to-root-ratio is the ratio of the length of the part of a tooth that appears above the alveolar bone versus what lies below it. It is an important consideration in the diagnosis, treatment planning and restoration of teeth, one that hopefully guides the plan of treatment to the proper end result.
In dental anatomy, 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 probe is gently inserted, slides by the sulcular epithelium (SE), and is stopped by the epithelial attachment (EA). However, the probing depth of the gingival sulcus may be considerably different from the true histological gingival sulcus depth.
The gingiva often possess a textured surface that is referred to as being stippled. Stippling only presents on the attached gingiva bound to underlying alveolar bone, not the freely moveable alveolar mucosa or free gingiva. Stippling used to be thought to indicate health, but it has since been shown that smooth gingiva is not an indication of disease, unless it is smooth due to a loss of previously existing stippling.
In dental anatomy, the gingival fibers are the connective tissue fibers that inhabit the gingival tissue (gums) adjacent to teeth and help hold the tissue firmly against the teeth. They are primarily composed of type I collagen, although type III fibers are also involved.
In dentistry, debridement refers to the removal by dental cleaning of accumulations of plaque and calculus (tartar) in order to maintain dental health. Debridement may be performed using ultrasonic instruments, which fracture the calculus, thereby facilitating its removal, as well as hand tools, including periodontal scaler and curettes, or through the use of chemicals such as hydrogen peroxide.
In dentistry, a furcation defect is bone loss, usually a result of periodontal disease, affecting the base of the root trunk of a tooth where two or more roots meet. The extent and configuration of the defect are factors in both diagnosis and treatment planning.
Chronic periodontitis is one of the seven categories of periodontitis as defined by the American Academy of Periodontology 1999 classification system. Chronic periodontitis is a common disease of the oral cavity consisting of chronic inflammation of the periodontal tissues that is caused by the accumulation of profuse amounts of dental plaque. Periodontitis initially begins as gingivitis and can progress onto chronic and subsequent aggressive periodontitis according to the 1999 classification.
Aggressive periodontitis describes a type of periodontal disease and includes two of the seven classifications of periodontitis as defined by the 1999 classification system:
In dentistry, numerous types of classification schemes have been developed to describe the teeth and gum tissue in a way that categorizes various defects. All of these classification schemes combine to provide the periodontal diagnosis of the aforementioned tissues in their various states of health and disease.
In periodontology, gingival grafting, also called gum grafting or periodontal plastic surgery, is a generic term for the performance of any of a number of surgical procedures in which the gingiva is grafted. The aim may be to cover exposed root surfaces or merely to augment the band of keratinized tissue.
Periodontal surgery is a form of dental surgery that prevents or corrects anatomical, traumatic, developmental, or plaque-induced defects in the bone, gingiva, or alveolar mucosa. The objectives of this surgery include accessibility of instruments to the root surface, elimination of inflammation, creation of an oral environment for plaque control, periodontal disease control, oral hygiene maintenance, maintaining proper embrasure space, addressing gingiva–alveolar mucosa problems, and esthetic improvement. Surgical procedures include crown lengthening, frenectomy, and mucogingival flap surgery.