Periodontal Disease Prediction System

Study Overview
=================
Brief Summary
-----------------
The purpose of this study was to develop a periodontal disease prediction software and a patient-based gingival recession simulator for clinical practice aiming at improving oral hygiene motivation of patients with periodontal problems.

Detailed Description
-----------------
Periodontal Disease Prediction (PDP) software has three components: a) Data Loading Window (DLW) b) Three-Dimensional Mouth Model (3DM) and c) Periodontal Attachment Loss Indicator (PLI). Demographic and clinical examinations of 1057 volunteers were recorded to DLW. An unsupervised machine learning K means clustering analysis was used to categorize the data obtained from the study population and identified the periodontal risk groups. An intraoral scanner was utilized to capture direct optical intraoral data of a patient and transferred to the 3DM. The intraoral model went under two algorithm steps for obtaining a recessed model. First, gingival curves separating gingiva and tooth were extracted using a Dijkstra's algorithm. Limit curves determining boundaries of recessed regions in the intraoral model were then obtained using gingival curves. The gingival recession was then mimicked by losing gingiva and disappearing tooth roots at proper locations in the intraoral model and Additionally, the final four different 3 dimensional recessed model (maxilla, mandibula, anterior teeth and posterior teeth) belonging to the same patient were scored based on the similarity to the real gingival recession by 25 periodontology specialist via online survey.

Official Title
-----------------
Periodontal Disease Prediction System and a Patient-Specific Gingival Recession Simulator

Conditions
-----------------
Periodontal Diseases

Intervention / Treatment
-----------------
* Diagnostic Test: Clinical examination


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Age greater than 18 years, Periodontal status ranging from no clinical periodontal disease (<10% with bleeding on probing) to periodontitis (stage I to IV) Patients having at least one teeth in each quadrant were included. Exclusion Criteria: Patients undergoing orthodontic treatment and using anti-inflammatory drugs were excluded.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Periodontal examination<br>Cross- sectional clinical periodontal examinations and measurements were performed using a Williams periodontal probe | Diagnostic Test: Clinical examination<br>* A total of 1057 individuals who applied to Bolu Abant İzzet Baysal University, Faculty of Dentistry, Department of Periodontology and agreed to participate in the study were clinically and radiologically examined. An intraoral scanner was utilized to capture direct optical intraoral data of a patient.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of sites Clinical Attachment Loss≥5 mm | Categorized as: None, <4, 4-8, >8 | Baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Presence of diabetes | Categorized as: Absence, diabetes with HbA1c<7, diabetes with HbA1c≥7 | Baseline | 
| Smoking status | Categorized as: None, < 10 per day, ≥10 per day | Baseline | 
| Patient cooperation and awareness | Categorized as: None, some, high | Baseline | 
| History of dental treatment | Categorized as: None, treated in the last 1 year | Baseline | 
| Tooth brushing Habits | Categorized as: None/ 1 time in day/ ≥2 times in day | Baseline | 
| Interproximal cleaning | Categorized as: None/ 1 time in day/ ≥2 times in day | Baseline | 
| Alveolar bone loss/age | Categorized as: None/ <0.25 /0.25-1/ >1 | Baseline | 
| Number of sites Probing Pocket Depth ≥5 mm | Categorized as: None/ <4 / 4-8/ >8 | Baseline | 
| Number of sites Bleeding on Probing (%) | Categorized as: <10%/ 10-25%/ >25% | Baseline | 
| Tooth mobility | Categorized as: None/ Miller I/ Miller II/ Miller III | Baseline | 
| Gingival phenotype | Categorized as: Thin/thick | Baseline | 
| Presence of furcation involvement | Categorized as: None/ horizontal involvement/ vertical involvement/ combined | Baseline | 
| Vertical alveolar bone loss | Categorized as: Presence/absence | Baseline | 
| Presence of endodontic tooth problem | Categorized as: Presence/absence | Baseline | 
| Number of tooth loss | Categorized as: None/ <4/ 4-8/ >8 | Baseline | 
| Traumatic occlusion | Categorized as: Presence/absence | Baseline | 
| Restorations including gingival margin | Categorized as: Presence/absence | Baseline | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
gingival recession, Oral hygiene motivation, Computer-aided design