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Comparison of Artificial Intelligence and Clinicians With Different Experience Levels in Assessing Gingival Phenotype

6 maja 2026 zaktualizowane przez: Sude Yildirim, Ondokuz Mayıs University

The goal of this observational study is to compare the performance of clinicians with different experience levels and a deep learning-based artificial intelligence (AI) model in assessing gingival phenotype using two diagnostic methods: the periodontal probe transparency method and visual assessment from standardized clinical photographs. The main questions the study aims to answer are:

Can AI achieve comparable accuracy to human examiners in both probe transparency and visual assessment methods?

Does examiner experience level influence diagnostic performance and agreement with the reference standard in these methods?

Researchers will compare AI, dental students, and periodontology research assistants to determine accuracy, sensitivity, specificity, and agreement with the gold standard for each method.

Participants will:

Undergo standardized intraoral photography of maxillary anterior teeth, with and without a periodontal probe in place, following a validated protocol.

Have gingival phenotype determined by a reference periodontologist using the probe transparency method as the gold standard.

Have their photographs evaluated by AI, dental students, and research assistants for phenotype classification using both methods.

Przegląd badań

Szczegółowy opis

Gingival phenotype, representing the thickness and morphological characteristics of the gingival soft tissues, plays a critical role in periodontal health, treatment planning, and the long-term stability of clinical outcomes. A thin phenotype is associated with increased risk of gingival recession, papilla loss, and inflammatory complications, while a thick phenotype offers better soft tissue stability but may mask inflammation. Accurate and reproducible assessment of gingival phenotype is therefore essential in clinical dentistry.

The periodontal probe transparency method is considered the gold standard for phenotype assessment due to its simplicity and non-invasiveness. In this method, a periodontal probe is inserted into the sulcus from the buccal aspect, and if the probe is visible through the gingival tissue, the phenotype is classified as thin; if not visible, it is classified as thick. However, the method is susceptible to variability depending on examiner experience, lighting conditions, and subjective interpretation.

Visual assessment, which relies solely on the inspection of gingival and tooth morphology in photographs without a probe, offers a non-contact alternative but is similarly subject to examiner-related variability. These limitations highlight the need for standardized and objective approaches to phenotype determination.

Artificial intelligence (AI), particularly deep learning-based image analysis, has shown promising results in dental diagnostics, enabling automated classification of clinical images with high accuracy and reproducibility. In periodontal research, AI has been applied for lesion detection and radiographic interpretation, but its application in gingival phenotype assessment-especially using the probe transparency method and visual assessment-remains unexplored.

This observational study aims to compare the diagnostic performance of a deep learning-based AI model with human examiners of different experience levels (periodontology residents vs. dental students) in assessing gingival phenotype from standardized intraoral photographs using both the periodontal probe transparency method and visual assessment. The reference standard will be the classification provided by an experienced periodontologist using the probe transparency method in a clinical setting.

The study will evaluate and compare accuracy, sensitivity, specificity, and inter-/intra-examiner agreement across examiner groups and the AI model. The findings are expected to provide insights into the potential of AI as a standardizing tool, reducing inter-examiner variability and supporting clinical decision-making, particularly for less experienced clinicians. Additionally, the study may inform the integration of AI-assisted diagnostic tools in dental education and practice, improving training efficiency and clinical outcomes.

Typ studiów

Obserwacyjny

Zapisy (Szacowany)

40

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Kontakt w sprawie studiów

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

  • Dorosły
  • Starszy dorosły

Akceptuje zdrowych ochotników

Tak

Metoda próbkowania

Próbka bez prawdopodobieństwa

Badana populacja

The study population will consist of systemically and periodontally healthy adults attending the Department of Periodontology at Ondokuz Mayıs University, Faculty of Dentistry, for routine dental care or check-up. Eligible participants will have natural maxillary anterior incisors and meet all inclusion criteria.

Additionally, the examiner population will include:

Periodontology research assistants currently working in the department.

Fourth- and fifth-year dental intern students who have completed the periodontology clinical rotation.

Opis

Inclusion Criteria for Volunteer Participants Who Will Participate in Transparency and Visual Assessment:

  • Systemically and periodontally healthy individuals.
  • Presence of natural maxillary anterior incisors.

Exclusion Criteria:

  • Presence of fixed crowns or cervical restorations on the evaluated teeth.
  • Pregnant or breastfeeding women.
  • Signs of gingival inflammation or periodontal disease with attachment loss.
  • Presence of buccal gingival recession.
  • Use of medications known to cause gingival enlargement.
  • Presence of congenital anomalies or dental structural defects.

Inclusion Criteria for Clinicians:

  • Research assistants: Must be currently working in the Department of Periodontology.
  • Dental Intern Students: Fourth- or fifth-year students who have completed periodontology clinical rotation.

Exclusion Criteria for Clinicians:

  • Those who are confirmed to be color blind by the Ishihara test

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

Kohorty i interwencje

Grupa / Kohorta
Interwencja / Leczenie
Dental Students
Fourth- and fifth-year dental intern students will assess standardized intraoral photographs using both the periodontal probe transparency method and visual assessment to classify gingival phenotype.
Standardized intraoral photography of the maxillary anterior teeth with a periodontal probe placed according to the transparency method protocol to determine probe visibility status.
Standardized intraoral photography of the maxillary anterior teeth without a periodontal probe, evaluated for gingival phenotype classification based on morphological features.
Artificial Intelligence Model
A deep learning-based image classification model will analyze standardized intraoral photographs, detecting probe visibility and classifying gingival phenotype according to the periodontal probe transparency method and visual assessment criteria.
Standardized intraoral photography of the maxillary anterior teeth with a periodontal probe placed according to the transparency method protocol to determine probe visibility status.
Standardized intraoral photography of the maxillary anterior teeth without a periodontal probe, evaluated for gingival phenotype classification based on morphological features.
A deep learning image classification algorithm trained to assess probe visibility and gingival phenotype from standardized intraoral photographs.
Periodontology Research Assistants
Research assistants in periodontology will assess standardized intraoral photographs using both the periodontal probe transparency method and visual assessment to classify gingival phenotype.
Standardized intraoral photography of the maxillary anterior teeth with a periodontal probe placed according to the transparency method protocol to determine probe visibility status.
Standardized intraoral photography of the maxillary anterior teeth without a periodontal probe, evaluated for gingival phenotype classification based on morphological features.

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Diagnostic Accuracy of Each Examiner Group and AI Model in the Periodontal Probe Transparency Method
Ramy czasowe: At the time of image evaluation (single session).

Accuracy in determining probe visibility (visible vs. not visible) compared to the gold standard classification by an experienced periodontologist.

Measure Type: Proportion (%). Analysis: Accuracy, sensitivity, specificity, and Cohen's kappa coefficient will be calculated.

At the time of image evaluation (single session).

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Diagnostic Accuracy of Each Examiner Group and AI Model in Visual Assessment Method
Ramy czasowe: At the time of image evaluation (single session).

Accuracy in classifying gingival phenotype (thin vs. thick) without probe, compared to the gold standard classification.

Measure Type: Proportion (%).

At the time of image evaluation (single session).
Agreement Between Examiner Groups and AI Model
Ramy czasowe: At the time of image evaluation and at 2-week retest (for a random subset of evaluators).
Inter-examiner and intra-examiner agreement for each method, evaluated using Cohen's kappa coefficient and intraclass correlation coefficient (ICC).
At the time of image evaluation and at 2-week retest (for a random subset of evaluators).
Effect of Examiner Experience Level on Diagnostic Performance
Ramy czasowe: At the time of image evaluation (single session).

Comparison of accuracy and agreement between research assistants and dental intern students for each method.

Proportion (%), agreement statistic.

At the time of image evaluation (single session).

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Publikacje i pomocne linki

Osoba odpowiedzialna za wprowadzenie informacji o badaniu dobrowolnie udostępnia te publikacje. Mogą one dotyczyć wszystkiego, co jest związane z badaniem.

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Szacowany)

15 maja 2026

Zakończenie podstawowe (Szacowany)

15 sierpnia 2026

Ukończenie studiów (Szacowany)

15 października 2026

Daty rejestracji na studia

Pierwszy przesłany

29 kwietnia 2026

Pierwszy przesłany, który spełnia kryteria kontroli jakości

29 kwietnia 2026

Pierwszy wysłany (Rzeczywisty)

6 maja 2026

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

11 maja 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

6 maja 2026

Ostatnia weryfikacja

1 maja 2026

Więcej informacji

Terminy związane z tym badaniem

Inne numery identyfikacyjne badania

  • OMUKAEK NO:225/335

Plan dla danych uczestnika indywidualnego (IPD)

Planujesz udostępniać dane poszczególnych uczestników (IPD)?

TAK

Opis planu IPD

De-identified individual participant data (IPD), including demographic characteristics, periodontal measurements, and standardized intraoral photographs, may be shared upon reasonable request for academic purposes. Access will require a data use agreement and approval by the principal investigator.

Ramy czasowe udostępniania IPD

De-identified IPD and supporting documents will be available within 12 months after publication of the main results and will remain available for at least 5 years.

Kryteria dostępu do udostępniania IPD

https://www.icmje.org/recommendations/browse/publishing-and-editorial-issues/clinical-trial-registration.html

Typ informacji pomocniczych dotyczących udostępniania IPD

  • PROTOKÓŁ BADANIA
  • SOK ROŚLINNY
  • ICF

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Nie

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .

Badania kliniczne na Gingival Phenotype Assessment

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