Evaluation of Gummy Smile With Artificial ıntelligence
Trial ID: NCT06819137
Status: ACTIVE_NOT_RECRUITING
Study type: OBSERVATIONAL
Start date: 2025-01-31
Completion date: 2025-03-02
Sponsor: Gazi University
Conditions: Gummy Smile
Interventions: Gingival visibility exceeding 3 mm during smiling
Locations: Zeynep Turgut Çankaya
Countries: Turkey (Türkiye)
Enrollment: 650
Age range: 18 Years - 55 Years
Sex: ALL

Summary:
A smile, as a nonverbal communication tool, is based on a balanced relationship between the teeth and the surrounding hard and soft tissues. The literature highlights the need for the evaluation of smile design using artificial intelligence (AI), suggesting that AI-assisted assessments could play a crucial role in all relevant stages of clinical parameters associated with gingival smile analysis. A gummy smile (GS) is defined as the excessive display of gingival tissue exceeding 3 mm during smiling.

The hypothesis of this study is based on the assumption that clinical data obtained for the analysis and diagnosis of gingival visibility can be accurately and reliably evaluated using AI-supported algorithms. To date, no study has been found in the literature that diagnoses GS using AI, predicts its etiological factors, and assesses its implications for treatment planning.

Eligibility criteria:
Inclusion Criteria:

Participants aged between 18 and 55 years.

Gingival Display During Smiling:

Presence of more than 3 mm of gingival display above the maxillary anterior teeth during smiling.

Gummy smile severity exceeding a predefined threshold, categorized as mild, moderate, or severe.

Oral and Periodontal Health:

Periodontally healthy individuals or those with minimal gingival inflammation. Anterior teeth free of caries or extensive restorations that may affect esthetic evaluation.

Participants with Class I occlusion or mild malocclusion.

Presence of etiological factors contributing to gummy smile, such as:

Vertical maxillary excess (VME) Hyperactive upper lip Altered passive eruption

History of Orthodontic or Surgical Treatment:

No history of previous gummy smile correction treatments. No orthodontic treatment or surgical intervention within the last 6-12 months.

Systemic Health and Medication Use:

Absence of systemic diseases or medication use that could influence gingival display.

Image Quality Requirements:

High-resolution and standardized photographs or video recordings. Images captured under consistent lighting conditions and fixed angles to ensure accurate evaluation of gingival display.

Exclusion Criteria:

Periodontal and Dental Conditions:

Presence of severe periodontal disease (e.g., periodontitis, gingival hyperplasia).

Extensive carious lesions, large restorations, or prosthetic crowns on anterior teeth.

History of traumatic dental injuries affecting the maxillary anterior region.

Occlusal and Skeletal Anomalies:

Severe malocclusion (e.g., Class II or III, open bite, crossbite). Jaw deformities requiring orthognathic surgery.

History of Previous Treatment for Gummy Smile:

Prior orthodontic treatment, periodontal surgery, or botulinum toxin injections for gummy smile correction.

History of orthognathic or maxillofacial surgery altering gingival display.

Systemic Health Conditions and Medication Use:

Presence of systemic diseases that could affect gingival tissue or facial muscle function (e.g., diabetes, neuromuscular disorders).

Use of medications known to induce gingival overgrowth, such as:

Calcium channel blockers Phenytoin Cyclosporine

Inadequate Image Quality for AI Analysis:

Low-resolution, blurred, or poorly standardized photographs. Inconsistent lighting conditions or improper facial positioning in images.

Pregnancy and Hormonal Influence:

Pregnant or postpartum individuals, as hormonal changes may temporarily influence gingival display.

Outcomes:
value of gummy smile visibility using artificial intelligence algorithms