Which statement about CAL is true?

Which statement about CAL is true?

• A. CAL is measured from the CEJ to the base of the pocket, accounting for recession.
• B. CAL is measured from the gingival margin to the crown.
• C. CAL is the same as probing depth for all cases.
• D. CAL is not used in PSR.

Answer: (A)

Clinical attachment level shows how much periodontal support has been lost by using a fixed reference point, the cementoenamel junction (CEJ). You measure CAL from the CEJ to the base of the pocket. This is why recession matters: when the gingival margin has receded, the base of the pocket moves away from the CEJ, increasing CAL even if probing depth is the same. For example, a probing depth of 4 mm with 2 mm of recession gives a CAL of 6 mm. If the gingival margin sits coronal to the CEJ due to gingival overgrowth, CAL can be less than the probing depth. This principle is why the statement about CAL being measured from the CEJ to the base of the pocket and accounting for recession is true, whereas measuring from the gingival margin to the crown, equating CAL with probing depth in all cases, or claiming CAL isn’t used in PSR do not fit.

Clinical attachment level shows how much periodontal support has been lost by using a fixed reference point, the cementoenamel junction (CEJ). You measure CAL from the CEJ to the base of the pocket. This is why recession matters: when the gingival margin has receded, the base of the pocket moves away from the CEJ, increasing CAL even if probing depth is the same. For example, a probing depth of 4 mm with 2 mm of recession gives a CAL of 6 mm. If the gingival margin sits coronal to the CEJ due to gingival overgrowth, CAL can be less than the probing depth. This principle is why the statement about CAL being measured from the CEJ to the base of the pocket and accounting for recession is true, whereas measuring from the gingival margin to the crown, equating CAL with probing depth in all cases, or claiming CAL isn’t used in PSR do not fit.