AI-Based Prediction of Root Coverage Outcome From Intraoral Photographs
16 août 2026 mis à jour par: Marmara University
Development and Internal Validation of a Deep Learning Model Predicting the Outcome of Root Coverage Surgery From Preoperative Intraoral Photographs: A Prospective Observational Cohort Study
This study evaluates whether the outcome of root coverage surgery can be predicted from a preoperative intraoral photograph.
Adults with Cairo RT1,RT2 or RT3 gingival recessions treated with a coronally advanced flap and a connective tissue graft are followed for six months.
Standardised photographs and clinical measurements are obtained before surgery and at each follow-up visit.
A deep learning model is developed to predict the surgical outcome from the preoperative photograph and baseline clinical variables, and its performance is compared with the outcome measured clinically at six months.
The model does not influence treatment decisions.
Aperçu de l'étude
Statut
Recrutement
Les conditions
Description détaillée
Whether an exposed root surface can be completely covered is the central question in planning mucogingival surgery. The Cairo classification is the current diagnostic standard for that judgement, but assignment of the recession type varies between examiners and prediction of the individual surgical outcome remains largely subjective. In this cohort, consecutive systemically healthy adults with Cairo RT1,RT2 or RT3 gingival recessions are treated by a single operator with a coronally advanced flap combined with a subepithelial connective tissue graft. Recession depth, keratinised tissue width and gingival thickness are recorded at baseline and at three and six months.
Standardised intraoral photographs are obtained at each time point under fixed conditions. A deep learning model is developed to predict the six-month outcome from the preoperative photograph together with baseline clinical variables. Model performance is assessed by discrimination, calibration and prediction error, using the clinical measurement at six months as the reference standard. A secondary analysis examines whether the recession type assigned automatically from the photograph agrees with the type assigned by the examining periodontist. The model is developed and validated internally within this cohort; no external validation set is available. Its output is not shown to the operator and does not influence treatment. Reporting follows the TRIPOD recommendations for prediction model studies.
Type d'étude
Observationnel
Inscription (Estimé)
36
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Coordonnées de l'étude
- Nom: Muhammed F Dogan, Resident
- Numéro de téléphone: +905433890065
- E-mail: mfurkandogaan@gmail.com
Lieux d'étude
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Istanbul
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Istanbul, Istanbul, Turquie (Türkiye), 34854
- Recrutement
- Marmara University Faculty of Dentistry Department of Periodontology
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Contact:
- Muhammed F Dogan, Resident
- Numéro de téléphone: +905433890065
- E-mail: mfurkandogaan@gmail.com
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Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
Oui
Méthode d'échantillonnage
Échantillon non probabiliste
Population étudiée
The study population consists of systemically healthy adult patients (aged 18-65) presenting to the Department of Periodontology at Marmara University with esthetic concerns or dentin hypersensitivity associated with gingival recession.
The cohort includes individuals diagnosed with Cairo Class RT1 or RT2 (Miller Class I or II) gingival recession defects who are scheduled to undergo mucogingival root coverage surgery.
La description
Inclusion Criteria:
- Systemically healthy patients (ASA I or II status) with no contraindications for periodontal surgery.
- Adult patients aged 18 to 65 years.
- Presence of isolated or multiple gingival recessions classified as Cairo RT1, RT2 or RT3 in the maxilla or mandible.
- Patients with good oral hygiene standards, defined as a Full Mouth Plaque Score (FMPS) and Full Mouth Bleeding Score (FMBS) of < 20% at baseline.
- Presence of an identifiable Cemento-Enamel Junction (CEJ) (Crucial for AI segmentation).
Exclusion Criteria:
- Patients with uncontrolled diabetes, immune system disorders, or pregnant/lactating women.
- Teeth with cervical restorations or abrasions that obscure the CEJ.
- Malpositioned or rotated teeth that would distort the photographic angle for AI analysis.
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
Cohortes et interventions
Groupe / Cohorte |
Intervention / Traitement |
|---|---|
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Root coverage surgery cohort
Systemically healthy adults aged 18 to 65 years with Cairo RT1,RT2 pr RT3 gingival recessions, treated with a coronally advanced flap combined with a subepithelial connective tissue graft by a single operator and followed for six months.
All participants received the same surgical technique; no comparison group was formed and no participant was assigned to a treatment for the purposes of this study.
Standardised intraoral photographs and clinical measurements were obtained before surgery and at three and six months.
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A coronally advanced flap is raised over the recession defect and a subepithelial connective tissue graft harvested from the palate is positioned beneath it, after which the flap is sutured coronal to the cemento-enamel junction.
Graft thickness, length and width are recorded for each treated site.
The procedure was performed as routine clinical care and was not assigned for research purposes.
Preoperative intraoral photographs and baseline clinical variables are analysed by a deep learning model that predicts the outcome of root coverage surgery.
The model output is not used in clinical decision making and does not influence treatment; it is compared retrospectively with the outcome measured by the treating periodontist at six months.
The same photographs are also used to assign the recession type automatically, which is compared with the clinical assignment.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Accuracy of the model in predicting root coverage at six months
Délai: 6 months
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Difference between the root coverage predicted by a model based on preoperative intraoral photographs and baseline clinical characteristics, and the root coverage observed at six months.
Root coverage is expressed as the percentage of the baseline recession depth that is covered, calculated as [(baseline recession depth - six-month recession depth) / baseline recession depth] × 100, from probing measurements made by the treating periodontist from the cemento-enamel junction to the gingival margin.
Predictive accuracy is summarised as the mean absolute error in percentage points across all treated sites.
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6 months
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Sensitivity and specificity of the model at the selected decision threshold
Délai: 6 months
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Proportion of sites correctly identified by the model among those that achieved the outcome (sensitivity) and among those that did not (specificity), evaluated at the operating point selected on the receiver operating characteristic curve.
Both proportions are reported with 95% confidence intervals.
The reference standard is the clinical measurement made at six months by the treating periodontist, using a periodontal probe from the cemento-enamel junction to the gingival margin.
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6 months
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Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Calibration of the model
Délai: 6 months
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Agreement between the probability predicted by the model and the frequency observed in the cohort, assessed by the calibration slope and intercept and displayed as a calibration plot.
Discrimination indicates whether the model ranks sites correctly; calibration indicates whether the predicted probabilities are numerically correct, and the two are reported separately because a model may rank well while producing miscalibrated probabilities.
The reference standard is the clinical measurement made at six months.
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6 months
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Agreement between the model-assigned and the clinician-assigned recession type
Délai: Baseline
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Proportion of treated sites at which the recession type assigned by the model from the preoperative photograph matches the type assigned by the examining periodontist, reported together with quadratic weighted kappa.
The reference standard is the clinical assignment recorded at baseline according to the criteria of Cairo et al.
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Baseline
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Les enquêteurs
- Chercheur principal: Leyla Kuru, Professor, Marmara University Faculty of Dentistry Department of Periodontology
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude (Réel)
17 septembre 2025
Achèvement primaire (Estimé)
17 septembre 2026
Achèvement de l'étude (Estimé)
17 septembre 2027
Dates d'inscription aux études
Première soumission
16 août 2026
Première soumission répondant aux critères de contrôle qualité
16 août 2026
Première publication (Réel)
20 août 2026
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
20 août 2026
Dernière mise à jour soumise répondant aux critères de contrôle qualité
16 août 2026
Dernière vérification
1 août 2026
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 2025-09-02/2025-58
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Non
Étudie un produit d'appareil réglementé par la FDA américaine
Non
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