Clinical Attachment Level
Also written as: CAL — Clinical Attachment Level
A measurement, in millimetres, of the distance from the cementoenamel junction to the base of the periodontal pocket, used to quantify the extent of periodontal attachment loss.
Full Definition
Clinical attachment level (CAL) is considered the gold standard measurement for tracking periodontal disease progression and treatment outcomes over time. It is calculated by adding the probing depth to the distance from the CEJ to the gingival margin when recession is present, or by subtracting the distance when the gingival margin is coronal to the CEJ. Unlike probing depth alone, CAL accounts for gingival margin position and thus more accurately reflects true attachment loss. An increase in CAL between appointments signals active disease progression. Editors must distinguish 'clinical attachment level' from 'probing depth,' as the two terms are not interchangeable.
Usage
Usage note: Abbreviate as CAL after first use. Do not conflate with 'probing depth (PD)'; CAL incorporates gingival margin position while PD does not.
In Context
- "A clinical attachment level of 5 mm on the mesial of tooth #14 was recorded, reflecting 2 mm of recession plus a 3 mm probing depth." — Periodontal re-evaluation chart note
- "Changes in clinical attachment level over successive visits provide the most reliable evidence of disease activity." — Periodontal case presentation