Perio questions

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albatross321

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-Given CEJ-GM distance is -1 and Probing depth is 5, is the CAL (calculated attachment loss) still 5?

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attachment loss = distance from bottom of pocket to CEJ right?
so attachment loss in this case should be 6
 
Dont think there is attachment loss, -1 score means that gingiva is located 1mm above cej. Score of 1 means recession of 1mm so you add to the sulcus. I think!
 
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When the gingival margin is located coronal to the CEJ = Negative number
When the gingival margin is located at the CEJ = 0
When the gingival margin is located apical to the CEJ = Positive Number

So in your example, the CEJ is -1 and the probing depth is 5 so CAL = 4
 
When the gingival margin is located coronal to the CEJ = Negative number
When the gingival margin is located at the CEJ = 0
When the gingival margin is located apical to the CEJ = Positive Number

So in your example, the CEJ is -1 and the probing depth is 5 so CAL = 4

In school, we studied bit like this: positive number meaning coronal to the CEJ, and negative - appital (as in plus and minus from the CEJ). So CAL according to me, will be 6.
 
In school, we studied bit like this: positive number meaning coronal to the CEJ, and negative - appital (as in plus and minus from the CEJ). So CAL according to me, will be 6.

I understand that you may have been taught that way in school, but that is not consistent with what is expected for the boards. Pull out Carranza's textbook, considered by most periodontists as the Bible of periodontology, and it's consistent with the method that I described.

By using anything coronal to the CEJ as a NEGATIVE number, you get the true measurement from the CEJ to the base of the pocket and a repeatable baseline measurement. If you use it as a positive number your saying that from the point of the free gingival margin to the base of the pocket is all attachment loss which is not accurate, does gingiva typically attach to enamel? Since we all know that the height of the gingiva can vary, depending on current oral hygiene, medications, etc. by using the FGM coronal to the CEJ as a positive number you establish an inaccurate baseline.
 
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