This study aims to develop and evaluate an artificial intelligence-based clinical image model for the detection, classification, and management recommendations of anterior gingival recession. The study will utilize clinical images of patients presenting with gingival recession to train and validate a machine learning model capable of accurately identifying and classifying the condition according to established clinical criteria. In addition, the model will provide preliminary treatment recommendations based on the severity and type of recession. This is a diagnostic and model-development study designed to support clinicians in improving the accuracy and consistency of diagnosis and treatment planning for gingival recession in the anterior region.

This study is designed to develop and validate an artificial intelligence (AI)-based clinical image analysis model for the detection, classification, and management recommendation of anterior gingival recession. Gingival recession is a common periodontal condition characterized by apical displacement of the gingival margin, which may lead to aesthetic concerns, dentinal hypersensitivity, and increased risk of root caries.

Clinical intraoral images of patients presenting with anterior gingival recession will be collected following standardized imaging protocols. The dataset will be used to train, validate, and test a machine learning model capable of identifying the presence of gingival recession and classifying its severity and/or type according to established periodontal classification systems.

The AI model will also be designed to generate preliminary management recommendations based on the detected class, supporting clinical decision-making. Model performance will be evaluated using standard metrics such as accuracy, sensitivity, specificity, precision, recall, and area under the receiver operating characteristic curve (AUC-ROC).

The study is observational in nature with a diagnostic and model-development component. All patient data will be anonymized to ensure confidentiality, and ethical approval will be obtained prior to data collection. The final output is intended to support clinicians in improving diagnostic consistency and treatment planning efficiency for anterior gingival recession.

Inclusion Criteria:

• Patients aged 18 years or older
• Presence of at least one anterior tooth exhibiting gingival recession classified according to the Cairo classification system (RT1, RT2, or RT3). - The gingival margin must be clearly visible.
• High-quality images (good focus, lighting, and resolution) are required.
• Clinically visible and intact cementoenamel junction (CEJ).

Exclusion Criteria:

• Presence of cervical restorations or fixed prostheses that interfere with CEJ identification.
• Patients undergoing active orthodontic treatment.
• Pregnant individuals, due to hormonal changes affecting gingival tissues.
• Images with poor photographic quality.

The study population will consist of adult patients presenting with gingival recession affecting anterior teeth and attending the outpatient clinics of the Faculty of Dental Medicine for Girls, Al-Azhar University. Participants with clinically visible anterior gingival recession and adequate clinical photographs suitable for image analysis will be included in the study.