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Artificial intelligence-assisted decision-making in third molar assessment using ChatGPT: is it really a valid tool?

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Summary

Artificial intelligence (AI) chatbots like ChatGPT can assist in evaluating mandibular third molars for extraction. With established guidelines, ChatGPT demonstrated substantial agreement with specialist assessments, improving decision-making accuracy.

Keywords:
Artificial IntelligenceChatGPTCone-beam computed tomographyOral radiologyThird molar extraction

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Area of Science:

  • Dentistry
  • Oral Surgery
  • Artificial Intelligence in Medicine

Background:

  • Artificial intelligence (AI) is increasingly integrated into medical applications.
  • Assessing mandibular third molars for extraction often requires specialist judgment.
  • The utility of AI chatbots in this diagnostic process is under investigation.

Purpose of the Study:

  • To evaluate ChatGPT's efficacy in assessing mandibular third molars for CBCT referral.
  • To compare AI-driven assessments with specialist decisions.

Main Methods:

  • 184 panoramic radiographs of mandibular third molars were analyzed.
  • Specialists determined the need for CBCT referral.
  • ChatGPT assessed cases with and without established guidelines (Rood et al., 1990).
  • Agreement was statistically analyzed using Cohen's kappa and Cochrane-Mantel-Haenszel tests.

Main Results:

  • Initial ChatGPT assessment showed low correlation (49%) with specialists.
  • After applying guidelines, correlation improved to 70% (moderate agreement).
  • With additional test cases and guidelines, correlation reached 91% (near-perfect agreement).
  • High correlation was maintained across different tooth positions and locations.

Conclusions:

  • ChatGPT can effectively analyze mandibular third molars using established guidelines.
  • AI chatbots show potential as tools to support specialist decision-making in oral surgery.
  • The accuracy of AI assessment significantly improves with the implementation of clinical guidelines.