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1: Total loss of attachment (clinical attachment loss, CAL) is the sum of 2: Gingival recession, and 3: Probing depth. Gingival recession, also known as gum recession and receding gums, is the exposure in the roots of the teeth caused by a loss of gum tissue and/or retraction of the gingival margin from the crown of the teeth. [1]
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]
The "severity" of disease refers to the amount of periodontal ligament fibers that have been lost, termed "clinical attachment loss". According to the 1999 classification, the severity of chronic periodontitis is graded as follows: [67] Slight: 1–2 mm (0.039–0.079 in) of attachment loss; Moderate: 3–4 mm (0.12–0.16 in) of attachment loss
Ultimately, tooth loss may occur if the condition is not halted. It is termed localized when less than 30% of sites around teeth are involved, and generalised when more than 30% are involved. clinical attachment loss can be used to determine the severity of the condition, where 1–2mm is slight, 3–4mm is moderate and more than 5mm is severe. [5]
This involve going over both smooth surfaces (tooth brushing instructions) and the use of interproximal aids (e.g. floss). Smoking cessation (if applicable): Smoking is a significant risk factor for AgP, with patients who smoke having more affected teeth with loss of clinical attachment and more bone loss than non-smoking patients with AgP. [48]
Necrotizing periodontitis (NP) is where the infection leads to attachment loss (destruction of the ligaments anchoring teeth in their sockets), but involves only the gingiva, periodontal ligament and alveolar ligament. If attachment loss is present in the disease, it is termed NP, unless the disease has progressed beyond the mucogingival ...
1: Total loss of attachment (clinical attachment loss, CAL) is the sum of 2: Gingival recession, and 3: Probing depth. As the original sulcular depth increases and the apical migration of the junctional epithelium has simultaneously occurred, the pocket is now lined by pocket epithelium (PE) instead of junctional epithelium (JE). [3]
Although it cannot cause periodontium damage in itself, [19] bruxism is known to be able to worsen attachment loss and tooth mobility if periodontal disease is already present. [20] Moreover, the severity of tooth mobility caused by bruxism also varies depending on the teeth grinding pattern and intensity of bruxism. [ 21 ]