Restorative Dentistry & Endodontics

Research Article

Diagnostic accuracy of ChatGPT-5 in evaluating root canal treatment and periapical pathosis on periapical radiographs: Waleed Almutairi, Mujahid Alnasser, Hanan Alharbi, Obadah Austah; Restor Dent Endod 2026;51(3):e29. Published online July 8, 2026; DOI: https://doi.org/10.5395/rde.2026.51.e29

Objectives
Artificial intelligence (AI) chatbots such as ChatGPT-5 (OpenAI) are increasingly used for dental radiograph interpretation, especially among patients seeking self-assessment. However, their diagnostic accuracy in endodontics remains unclear. Methods: This cross-sectional STARD-AI-compliant study analyzed 271 anonymized periapical radiographs of endodontically treated posterior teeth, classified as straightforward (n = 167) or complex (n = 104), using standardized ChatGPT-5 prompts. Diagnostic criteria included obturation length (short, adequate, long), presence of voids, and periapical pathosis. Results were compared to those of a panel of general dentists and a reference standard from endodontic specialists. Sensitivity, specificity, and accuracy were calculated using the McNemar test (p < 0.05). Results: ChatGPT-5 demonstrated high specificity (up to 99.3%) for normal or adequately treated findings but low sensitivity for short (13.7%) or long (0.0%) obturations, voids (9.0%–22.7%), and periapical lesions (10.5%–28.6%). Overall accuracy (54.0%–63.2%) was significantly lower than that of general dentists (76.0%–85.6%) (p < 0.001). Conclusions: Although ChatGPT-5 achieved high specificity, its low sensitivity and overall accuracy limit diagnostic reliability. Expert clinician oversight remains essential for accurate interpretation and treatment planning.

Citations

Citations to this article as recorded by

Diagnostic Accuracy of Two Multimodal Artificial Intelligence Systems Versus Dental Students in Endodontic Radiographic Classification
Andrea Spinelli, Emanuele Charles, Maria Giovanna Gandolfi, Carlo Prati, Fausto Zamparini
Dentistry Journal.2026; 14(10): 679. CrossRef

1,850 View
93 Download
1 Crossref

First
Prev
Page of 1
Next
Last

Search