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Diabetes ComplicationsPARODIABNOSTICNCT05890807

Concordance in Diagnosis of Periodontitis in Diabetic Patients Between an Indirect Method Based on a Photograph of the Oral Cavity and a Direct Method Based on the Clinical Examination of This Oral Cavity (Reference).

A study testing Front view photography of the patient's oral cavity with the help of a smartphone in the diabetology department. in people with Diabetes Complications and Periodontal Diseases, run by Centre Hospitalier Universitaire de Nīmes at 1 site in France.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Periodontitis, a known complication of diabetes, is an infectious disease that destroys bone and gums. Studies have shown that diabetes favors periodontitis, and that periodontitis contributes to its aggravation. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Diabetes Complications, Periodontal Diseases
What is being tested?
Front view photography of the patient's oral cavity with the help of a smartphone in the diabetology department.
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
145 participants
Where
1 siteFrance
Study dates
20 Mar 2023to 31 Dec 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients with type 1 or 2 diabetes.
  • Patients of legal age (≥ 18 years).
  • Patient undergoing day or weekday hospitalization in the Metabolic and Endocrine Diseases Department at Nîmes University Hospital.
  • Patient who has not reported his or her opposition to participating in the study.
  • Patient affiliated or beneficiary of a health insurance plan.

Who cannot join

  • Patient who has received treatment for periodontal disease within the past 12 months.
  • Patient with fewer (<) than 3 functional contiguous teeth.
  • Patient participating in research involving human subjects defined as category 1.
  • Patient in an exclusion period as determined by another study.
  • Patient under court protection, guardianship, or conservatorship.
  • Patient for whom informed information cannot be provided.
  • Patient who is pregnant or breastfeeding.

Trial locations and contacts

1 site in 1 country.

France1 site
  • Chu de Nimes

    Nîmes, 30029

Other trials in France

About this study

Official title: Evaluation of the Concordance in the Diagnosis of Periodontitis in Diabetic Patients Between an Indirect Method Based on a Photograph of the Oral Cavity and a Direct Method Based on the Clinical Examination of This Oral Cavity (Reference).

Periodontitis, a known complication of diabetes, is an infectious disease that destroys bone and gums. Studies have shown that diabetes favors periodontitis, and that periodontitis contributes to its aggravation. The positive impact of treating periodontitis on the cost of diabetes care has been demonstrated and the French national health system fully covers the treatment of periodontitis for diabetic patients. Unfortunately, 80% of diabetic patients do not visit their dentist enough.

Although diabetologists regularly see their patients and are aware of the importance of treating periodontitis,they do not have the expertise to diagnose the condition whereas a specialist dentist can often diagnose it just by looking.

Read more

This study aims to develop a solution combining the dentist's expertise with that of the diabetologist. This would be based on analysis of a photograph of the patient's oral cavity, taken in the department. So far, no studies have ever evaluated the performance of an expert dentist for diagnosing periodontitis from a simple photograph made by non-dental experts in a diabetic department.

The hypothesis is that the concordance in the diagnosis of periodontitis between an indirect method based on a photograph of the oral cavity and a direct method based on clinical examination of this oral cavity (reference) in the diabetic patient would be satisfactory.

Read the detailed description

Among the complications of diabetes, periodontitis, an infectious disease that destroys the bone and gums, has a bidirectional relationship with diabetes. Indeed, studies have shown that diabetes favors periodontitis, and that periodontitis contributes to the aggravation of diabetes. In addition, the positive impact of treating periodontitis on the indicators and cost of diabetes management has been demonstrated. To echo these findings, since 2020, the French national health scheme now fully covers the treatment of periodontitis in diabetic patients. Unfortunately, health insurance reports point out that 80% of diabetic patients do not visit their dentist enough.

This makes it difficult to detect and treat periodontitis in diabetic patients at an early stage. At the same time, diabetologists who regularly see their patients confirm the importance of knowing their periodontal condition. But they do not have the expertise to diagnose periodontitis whereas, in most cases, a specialist dentist could diagnose it just by looking. The development of a solution allowing the dentist's expertise to be brought to the service of diabetes may have a positive impact on the management of diabetic patients with periodontitis. This expertise could be based on analyzing a photograph of the patient's oral cavity, taken in the department. So far, no studies have ever evaluated the performance of an expert dentist for diagnosing periodontitis from a simple photograph, made by non-dental experts in a diabetic department.

The hypothesis is that the concordance in the diagnosis of periodontitis between an indirect method based on a photograph of the oral cavity and a direct method based on clinical examination of this oral cavity (reference) in the diabetic patient would be satisfactory.

Being tested
Front view photography of the patient's oral cavity with the help of a smartphone in the diabetology department.
Keywords
Diabetes, Periodontitis
Medical subject headings
Diabetes Complications, Periodontal Diseases, Diabetes Mellitus, Periodontitis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Front view photography of the patient's oral cavity with the help of a smartphone in the diabetology department.Diagnostic test

    The diabetologist will take a photograph of the patient's oral cavity in the diabetology department.

Study groups in NCT05890807
Study groupRoleWhat they receive
Patients whose oral cavity will be photographed in the diabetology departmentExperimentalThe patient is seated in the chair. The trained staff member positions the mouth guard and takes a frontal photograph of the patient's oral cavity using the photo sensor (smart-phone). Only the oral cavity will be visible in the photograph and there will be no possibility for an external assessor to recognize the patient's face.
Receives: Diagnostic Test: Front view photography of the patient's oral cavity with the help of a smartphone in the diabetology department.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Parodontitis based on a photograph of the patient's oral cavity (indirect method)

    For the indirect method, two expert dentists will independently analyze the photographs in order to decide whether YES / NO the patient has parodontitis.

    Measured: Day 0 to day 7

  2. Parodontitis based on clinical observation of the patient's oral cavity (direct method)

    For the direct method by clinical examination, an expert dentist different from those involved in the indirect method will decide whether YES / NO the patient has parodontitis.

    Measured: Day 0

Secondary outcomes (30)
  1. A. Sensitivity and specificity of the Positive Predictive Value (NPV) measured by the indirect method

    Positive predictive value = True Positive / (True Positives+False Positives)

    Measured: Day 0 to day 7

  2. A. Sensitivity and specificity of the Negative Predictive Value (NPV) measured by the indirect method

    Negative predictive value = True Negative / (False Negatives + True Negatives)

    Measured: Day 0 to day 7

  3. A. Sensitivity and specificity of the Positive Predictive Value (PPV) measured by the direct method

    Positive predictive value = True Positive / (True Positives+False Positives)

    Measured: Day 0

  4. A. Sensitivity and specificity of the Positive Predictive Value (PPV) measured by the indirect method

    Negative predictive value = True Negative / (False Negatives+True Negatives)

    Measured: Day 0 to day 7

  5. B. Quality of photographs taken by the diabetology department : respect of anonymity

    Evaluation of the photograph by two expert dentists who check compliance with the rules established for taking the photo.

    During the research or at its conclusion, the data collected on the persons who lend themselves to it and transmitted to the sponsor by the investigators (or any other specialized intervening parties) will be made anonymous. Under no circumstances will the names of the persons concerned or their addresses appear in clear text. The patient will be identified only by a unique seven-digit identification number. A list of subject identifications will be kept in the investigator's file. The investigator will ensure that the anonymity of each individual participating in the study is guaranteed. No identifying information will be given to any third party other than those who are authorized by law to hold such information (and who are bound by professional secrecy).

    Measured: Day 0 to day 7

  6. B. Quality of photographs taken by the diabetology department : visibility of the gums

    Two expert dentists will check compliance with the rules established for taking the photo. For sufficient diagnostic quality, the gums must be clearly visible. "Periodontal disease" describes all gingivitis and periodontitis. Gingivitis is characterized by gingival inflammation manifested by redness of the gums, bleeding and localized edema. The inflammatory process only affects the superficial periodontium (gingival epithelium and gingival connective tissue) and is most often due to an accumulation of bacterial plaque. However, it can be reversed with specific oral hygiene measures. When the deep periodontal tissues (alveolar bone, periodontal ligament, cementum) are affected it is called periodontitis. These lesions are clinically characterized by gingival inflammation and a periodontal pocket (space that is created between the tooth and the gum) as well as by bone loss.

    Measured: Day 0 to day 7

  7. B. Quality of photographs taken by the diabetology department : image sharpness

    Evaluation of the photograph by two expert dentists who check compliance with the rules established for taking the photo. Is the image sharpness good enough to clearly visualize the patient's gums? YES/NO

    Measured: Day 0 to day 7

  8. B. Quality of photographs taken by the diabetology department : use of the flash

    Evaluation of the photograph by two expert dentists who check compliance with the rules established for taking the photo. Was the flash used ? YES/NO

    Measured: Day 0 to day 7

  9. B. Quality of photographs taken by the diabetology department : absence of zoom

    Evaluation of the photograph by two expert dentists who check compliance with the rules established for taking the photo.Was the zoom used? YES/NO

    Measured: Day 0 to day 7

  10. B. Quality of photographs taken by the diabetology department : orientation

    Evaluation of the photograph by two expert dentists who check compliance with the rules established for taking the photo. Was the photo taken from full front view ? YES/NO

    Measured: Day 0 to day 7

  11. B. Percentage of photographs meeting all of the above criteria for acceptance

    The number of photographs that meet all the above acceptance criteria will be converted into a percentage.

    Measured: Day 0 to day 7

  12. C. Association between the patient's diabetic constants and his/her periodontal status. Hospitalization

    Diabetic findings according to the following criteria recorded for each patient included:

    • the type of hospitalization (day or week)

    Measured: Day 0

  13. C. Association between the patient's diabetic constants and his/her periodontal status. Type of diabetes

    Diabetic findings according to the following criteria recorded for each patient included:

    -the type of diabetes (Type I, Type II or other)

    Measured: Day 0

  14. C. Association between the patient's diabetic constants and his/her periodontal status. Age of diabetes

    Diabetic findings according to the following criteria recorded for each patient included:

    • Age of diabetes: <1 year, 1-5 years, 5-10 years, 10-20 years, >20 years

    Measured: Day 0

  15. C. Association between the patient's diabetic constants and his/her periodontal status. Treatment

    Diabetic findings according to the following criteria recorded for each patient included:

    -treatment: insulin therapy yes/no and the drug used (metformin, hypoglycemic sulfonamides, dipeptidyl peptidase IV inhibitors, SGLT2 inhibitors, GLP1 analogues, other) will be recorded.

    Measured: Day 0

  16. C. Association between the patient's diabetic constants and his/her periodontal status.HbA1c level

    Diabetic findings according to the following criteria recorded for each patient included:

    • the patient's HbA1c level will be recorded in mmol/mol

    Measured: Day 0

  17. C. Association between the patient's diabetic constants and his/her periodontal status. Macrovascular complications

    Diabetic findings according to the following criteria recorded for each patient included:

    -Presence of macrovascular complications will be recorded as YES/NO

    Measured: Day 0

  18. C. Association between the patient's diabetic constants and his/her periodontal status. Type of macrovascular complication

    Diabetic findings according to the following criteria recorded for each patient included:

    -The type of macrovascular complication : arteriopathy (cerebral, coronary, lower limbs) will be recorded

    Measured: Day 0

  19. C. Association between the patient's diabetic constants and his/her periodontal status. Microvascular complications

    Diabetic findings according to the following criteria recorded for each patient included:

    -presence of microvascular complications, YES/NO

    Measured: Day 0

  20. C. Association between the patient's diabetic constants and his/her periodontal status. Type of microvascular complication

    Diabetic findings according to the following criteria recorded for each patient included:

    -The type of microvascular complication (retinopathy, nephropathy, neuropathy) will be recorded

    Measured: Day 0

  21. C. Association between the patient's diabetic constants and his/her periodontal status. Smoking

    Diabetic findings according to the following criteria recorded for each patient included:

    • the patient's smoking status (active/number of cigarettes per day/ex-smoker) will be recorded

    Measured: Day 0

  22. C. Association between the patient's diabetic constants and his/her periodontal status. Periodontitis

    Diabetic findings according to the following criteria recorded for each patient included:

    Presence of periodontitis (yes/no) according to the reference method, i.e. by odontological examination.

    Measured: Day 0

  23. D. Visible clinical signs associated with periodontitis on the photos taken. Inflammation

    Evaluation of clinical signs visible on the photos of diabetic patients diagnosed with periodontitis according to the gold standard (odontological examination):

    -Inflammatory color of the gum The evaluation will be interpreted by two blinded expert dentists (different from the one who performed the odontological examination) at the end of the inclusion period.

    Observation of the photographs by two expert dentists.

    Measured: Day 0 to day 7

  24. D. Visible clinical signs associated with periodontitis on the photos taken. Root tartar

    Evaluation of clinical signs visible on the photos of diabetic patients diagnosed with periodontitis according to the gold standard (odontological examination):

    -Root tartar The evaluation will be interpreted by two blinded expert dentists (different from the one who performed the odontological examination) at the end of the inclusion period.

    Observation of the photographs by two expert dentists.

    Measured: Day 0 to day 7

  25. D. Visible clinical signs associated with periodontitis on the photos taken. Pus

    Evaluation of clinical signs visible on the photos of diabetic patients diagnosed with periodontitis according to the gold standard (odontological examination):

    -Pus The evaluation will be interpreted by two blinded expert dentists (different from the one who performed the odontological examination) at the end of the inclusion period.

    Observation of the photographs by two expert dentists.

    Measured: Day 0 to day 7

  26. D. Visible clinical signs associated with periodontitis on the photos taken. Bleeding

    Evaluation of clinical signs visible on the photos of diabetic patients diagnosed with periodontitis according to the gold standard (odontological examination):

    -Bleeding The evaluation will be interpreted by two blinded expert dentists (different from the one who performed the odontological examination) at the end of the inclusion period.

    Observation of the photographs by two expert dentists.

    Measured: Day 0 to day 7

  27. D. Visible clinical signs associated with periodontitis on the photos taken. Interdental space

    Evaluation of clinical signs visible on the photos of diabetic patients diagnosed with periodontitis according to the gold standard (odontological examination):

    -Interdental space The evaluation will be interpreted by two blinded expert dentists (different from the one who performed the odontological examination) at the end of the inclusion period.

    Observation of the photographs by two expert dentists.

    Measured: Day 0 to day 7

  28. D. Visible clinical signs associated with periodontitis on the photos taken. Gum retraction

    Evaluation of clinical signs visible on the photos of diabetic patients diagnosed with periodontitis according to the gold standard (odontological examination):

    -Retraction of the gum The evaluation will be interpreted by two blinded expert dentists (different from the one who performed the odontological examination) at the end of the inclusion period.

    Observation of the photographs by two expert dentists.

    Measured: Day 0 to day 7

  29. D. Visible clinical signs associated with periodontitis on the photos taken. Swollen gums

    Evaluation of clinical signs visible on the photos of diabetic patients diagnosed with periodontitis according to the gold standard (odontological examination):

    -Gum swelling The evaluation will be interpreted by two blinded expert dentists (different from the one who performed the odontological examination) at the end of the inclusion period.

    Observation of the photographs by two expert dentists.

    Measured: Day 0 to day 7

  30. D. Visible clinical signs associated with periodontitis on the photos taken. Plaque

    Evaluation of clinical signs visible on the photos of diabetic patients diagnosed with periodontitis according to the gold standard (odontological examination):

    -Dental plaque The evaluation will be interpreted by two blinded expert dentists (different from the one who performed the odontological examination) at the end of the inclusion period.

    Observation of the photographs by two expert dentists.

    Measured: Day 0 to day 7

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Jun 2023
  2. Study start20 Mar 2023
  3. Primary completion29 Feb 2024
  4. Study completion31 Dec 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Diagnosis
Allocation
Not applicable
Intervention model
Single group
Model description
A prospective, single-center, open-label, cross-sectional study to evaluate the concordance of an intervention versus the "gold standard.
Masking
None (open label)
Enrolment
145 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05890807
Sponsor's protocol ID
2022-A02129-34
Acronym
PARODIABNOSTIC
Status last verified
Mar 2025
First submitted
15 May 2023
Last updated
7 Mar 2025
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Front view photography of the patient's oral cavity with the help of a smartphone in the diabetology department. in people with Diabetes Complications and Periodontal Diseases, run by Centre Hospitalier Universitaire de Nīmes at 1 site in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 7 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Parodontitis based on a photograph of the patient's oral cavity (indirect method) (time frame: Day 0 to day 7). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Mar 2025.

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