Artificial Intelligence Evaluation of Periodontal Health Using Selfie Intraoral Photography
Trial ID: NCT04326413
Status: COMPLETED
Study type: OBSERVATIONAL
Start date: 2023-01-01
Completion date: 2025-03-24
Sponsor: The University of Hong Kong
Conditions: Gingivitis
Interventions: Oral hygiene instruction and simple scaling
Locations: Prince Philip Dental Hospital
Countries: Hong Kong
Enrollment: 100
Age range: 18 Years - None
Sex: ALL

Summary:
Periodontal (gum) disease affecting more than 90% of the population globally. The soft and hard tissues that supporting the teeth are being affected. If untreated, the disease progresses from the mild and reversible form (i.e. gingivitis) that involves superficial gum only to the more severe and irreversible form (i.e. periodontitis) that involves loss of periodontal ligament and bone. Teeth will be lost eventually and significantly impairs the function and the oral health related quality of health. Moreover, periodontal disease has been strongly linked to the systemic diseases via centrally or local routes with significant health implications.

Periodontal disease is initiated by bacteria (plaque) adhere on tooth surfaces and the body defense by eliciting inflammatory response. The disease and associated inflammation is site-specific and the affected gum is manifested with the cardinal signs of inflammation such as redness (color), swelling (increased volume), edema (loss of surface characteristics) and bleeds easily. Dentists are trained to identify the disease sites by visual (redness and swelling) and by mechanical probing (bleeding). Traditionally these give rises to clinical gum indices showing the degree of inflammation and are important to the clinical monitoring and management of gum diseases.

The management of periodontal disease involves the removal of bacteria plaque by both dentists' tooth cleaning and maintained by patients' daily home-care. Home-care plaque removal has been shown by many studies to prevent and/or cease the development of periodontitis. However, most patients do not able to remove plaque effectively and it only takes few days for a health site to development inflammation. Professional monitoring and feedback are highly desirable but many patients only have monthly or even yearly appointment which is too late. Such "non-compliance" increase the treatment cost/time, patient discomfort and reduce treatment efficacy. Moreover, many patients do not receive regular dental checkup and they seek dentists when the gum problem becomes irreversible that complicated and expensive treatment such as tooth extraction and rehabilitation is required.

This study consists of 1) collecting the standardized clinical photography with clinical gum indices/ marked by an experienced clinician, 2) import into computer for training, and 3) longitudinally monitoring and analyze of gum condition in a group of gingivitis patients receiving gum treatment.

Eligibility criteria:
Inclusion Criteria:

* Adult subjects attending PPDH and are able to give informed consent
* Subjects who diagnosed to have gingivitis only and have 24 or more teeth
* Subjects who are otherwise medically health
* Subjects who are able to attend multiple dental visits

Exclusion Criteria:

* Subjects who are in acute dental infection or in pain
* Subjects who have oral mucosal diseases that preclude retraction of soft tissues for photos
* Subjects who are in fixed appliance for orthodontic treatment
* Subjects who are pregnancy, or medically unfit for periodontal charting or requires antibiotic coverage (e.g. risk of infective endocarditis)

Outcomes:
Clinical gingival inflammation at 3 month; Photographic gingival inflammation at 3 month; Photographic gingival inflammation at baseline; Clinical gingival inflammation at baseline