Performance of three artificial intelligence (AI)‐based large language models in standardized testing; implications for AI‐assisted dental education
Open accessAbstract
Introduction: The emerging rise in novel computer technologies and automated data analytics has the potential to change the course of dental education. In line with our long‐term goal of harnessing the power of AI to augment didactic teaching, the objective of this study was to quantify and compare the accuracy of responses provided by ChatGPT (GPT‐4 and GPT‐3.5) and Google Gemini, the three primary large language models (LLMs), to human graduate students (control group) to the annual in‐service examination questions posed by the American Academy of Periodontology (AAP). Methods: Under a comparative cross‐sectional study design, a corpus of 1312 questions from the annual in‐service examination of AAP administered between 2020 and 2023 were presented to the LLMs. Their responses were analyzed using chi‐square tests, and the performance was juxtaposed to the scores of periodontal residents from corresponding years, as the human control group. Additionally, two sub‐analyses were performed: one on the performance of the LLMs on each section of the exam; and in answering the most difficult questions. Results: ChatGPT‐4 (total average: 79.57%) outperformed all human control groups as well as GPT‐3.5 and Google Gemini in all exam years ( p < .001). This chatbot showed an accuracy range between 78.80% and 80.98% across the various exam years. Gemini consistently recorded superior performance with scores of 70.65% ( p = .01), 73.29% ( p = .02), 75.73% ( p < .01), and 72.18% ( p = .0008) for the exams from 2020 to 2023 compared to ChatGPT‐3.5, which achieved 62.5%, 68.24%, 69.83%, and 59.27% respectively. Google Gemini (72.86%) surpassed the average scores achieved by first‐ (63.48% ± 31.67) and second‐year residents (66.25% ± 31.61) when all exam years combined. However, it could not surpass that of third‐year residents (69.06% ± 30.45). Conclusions: Within the confines of this analysis, ChatGPT‐4 exhibited a robust capability in answering AAP in‐service exam questions in terms of accuracy and reliability while Gemini and ChatGPT‐3.5 showed a weaker performance. These findings underscore the potential of deploying LLMs as an educational tool in periodontics and oral implantology domains. However, the current limitations of these models such as inability to effectively process image‐based inquiries, the propensity for generating inconsistent responses to the same prompts, and achieving high (80% by GPT‐4) but not absolute accuracy rates should be considered. An objective comparison of their capability versus their capacity is required to further develop this field of study.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The rise of <scp>ChatGPT</scp> : Exploring its potential in medical education
Lee, H. (2024) · Anatomical Sciences Education · doi:10.1002/ase.2270 · Cited by 596 · cited 1× · see citing works
“9,10 13 Concerns like this are especially relevant to healthcare academia, where AI-based training and testing curricula are being developed.”
Wach, K., Duong, C. D., Ejdys, J., Kazlauskaitė, R., Korzynski, P., Mazurek, G., Paliszkiewicz, J., & Ziemba, E. (2023) · Entrepreneurial Business and Economics Review · doi:10.15678/eber.2023.110201 · Cited by 584 · see citing works
Science in the age of large language models
Birhane, A., Kasirzadeh, A., Leslie, D., & Wachter, S. (2023) · Nature Reviews Physics · doi:10.1038/s42254-023-00581-4 · Cited by 344 · see citing works
Homolak, J. (2023) · Croatian Medical Journal · doi:10.3325/cmj.2023.64.1 · Cited by 208 · see citing works
Humar, P., Asaad, M., Bengur, F. B., & Nguyen, V. (2023) · Aesthetic Surgery Journal · doi:10.1093/asj/sjad130 · Cited by 155 · see citing works
ChatGPT for healthcare providers and patients: Practical implications within dermatology
Jin, J. Q., & Dobry, A. S. (2023) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2023.05.081 · Cited by 49 · see citing works
Flagged first, then by citations
Research works printed but not linked: 25
- [1]Kopytko V, Shevchuk L, Yankovska L, Semchuk Z, Strilchuk R. Smart home and artificial intelligence as environment for the implementation of new technologies. Traekt Nauki=Path Sci. 2018; 4: 2007‐ 2012.
- [2]Xu L, Sanders L, Li K, Chow JC. Chatbot for health care and oncology applications using artificial intelligence and machine learning: systematic review. JMIR Cancer. 2021; 7: e27850. 34847056 PMC8669585
- [3]Teng M, Ren Y. Application and development prospect of artificial intelligence in the daily life of the elderly and disabled. In: 2021 3rd International Conference on Machine Learning, Big Data and Business Intelligence (MLBDBI). IEEE; 2021: 767‐ 770.
- [4]Holmes J, Liu Z, Zhang L, et al. Evaluating large language models on a highly‐specialized topic, radiation oncology physics. Front Oncol. 2023; 13: 1219326. 37529688 PMC10388568
- [5]Thirunavukarasu AJ, Ting DSJ, Elangovan K, Gutierrez L, Tan TF, Ting DSW. Large language models in medicine. Nat Med. 2023; 29: 1930‐ 1940. 37460753
- [7]Cocci A, Pezzoli M, Lo Re M, et al. Quality of information and appropriateness of ChatGPT outputs for urology patients. Prostate Cancer Prostatic Dis. 2023; 27(1): 103‐ 108. doi: 10.1038/s41391-023-00705-y. 37516804 · DOI
- [9]Shah NH, Entwistle D, Pfeffer MA. Creation and adoption of large language models in medicine. JAMA. 2023; 330: 866‐ 869. 37548965
- [10]Harris E. Large language models answer medical questions accurately, but can't match clinicians' knowledge. JAMA. 2023; 330: 792. 37548971
- [14]Huang RS, Lu KJQ, Meaney C, Kemppainen J, Punnett A, Leung FH. Assessment of resident and AI Chatbot performance on the University of Toronto Family Medicine Residency Progress Test: comparative study. JMIR Med Educ. 2023; 9: e50514. 37725411 PMC10548315
- [16]Najafali D, Reiche E, Araya S, et al. Bard versus the 2022 American Society of Plastic Surgeons in‐service examination: performance on the examination in its intern year. Aesthetic Surg J Open Forum. 2023; 6: ojad066. PMC10776237 38196964
- [17]Vaishya R, Iyengar KP, Patralekh MK, et al. Effectiveness of AI‐powered Chatbots in responding to orthopaedic postgraduate exam questions—an observational study. Int Orthop. 2024. Epub ahead of print. doi: 10.1007/s00264-024-06182-9 38619565 · DOI
- [18]Dwivedi YK, Kshetri N, Hughes L, et al. Opinion Paper: “so what if ChatGPT wrote it?” Multidisciplinary perspectives on opportunities, challenges and implications of generative conversational AI for research, practice and policy. Int J Inf Manage. 2023; 71: 102642.
- [19]Thapa S, Adhikari S. ChatGPT, Bard, and large language models for biomedical research: opportunities and pitfalls. Ann Biomed Eng. 2023; 51: 2647‐ 2651. 37328703
- [20]Ali R, Tang OY, Connolly ID, et al. Performance of ChatGPT, GPT‐4, and Google Bard on a neurosurgery oral boards preparation question Bank. Neurosurgery. 2023; 93(5): 1090‐ 1098. 37306460
- [21]Rahsepar AA, Tavakoli N, Kim GHJ, Hassani C, Abtin F, Bedayat A. How AI responds to common lung cancer questions: ChatGPT vs Google Bard. Radiology. 2023; 307: e230922. 37310252
- [22]Haver HL, Lin CT, Sirajuddin A, Yi PH, Jeudy J. Use of ChatGPT, GPT‐4, and Bard to improve readability of ChatGPT's answers to common questions on lung cancer and lung cancer screening. AJR Am J Roentgenol. 2023; 221: 701‐ 704. 37341179
- [23]Achiam J, Adler S, Agarwal S, et al. GPT‐4 technical report. arXiv preprint arXiv:230308774 2023.
- [24]Takagi S, Watari T, Erabi A, Sakaguchi K. Performance of GPT‐3.5 and GPT‐4 on the Japanese medical licensing examination: comparison study. JMIR Med Educ. 2023; 9: e48002. 37384388 PMC10365615
- [25]Kung TH, Cheatham M, Medenilla A, et al. Performance of ChatGPT on USMLE: potential for AI‐assisted medical education using large language models. PLOS Digit Health. 2023; 2: e0000198. 36812645 PMC9931230
- [26]Massey PA, Montgomery C, Zhang AS. Comparison of ChatGPT‐3.5, ChatGPT‐4, and Orthopaedic resident performance on orthopaedic assessment examinations. J Am Acad Orthop Surg. 2023; 31: 1173‐ 1179. 37671415 PMC10627532
- [27]Farajollahi M, Modaberi A. Can ChatGPT pass the “Iranian Endodontics Specialist Board” exam? Iran Endod J. 2023; 18: 192. 37431530 PMC10329760
- [28]Danesh A, Pazouki H, Danesh K, Danesh F, Danesh A. The performance of artificial intelligence language models in board‐style dental knowledge assessment: a preliminary study on ChatGPT. J Am Dent Assoc. 2023; 154: 970‐ 974. 37676187
- [29]Danesh A, Pazouki H, Danesh F, Danesh A, Vardar‐Sengul S. Artificial intelligence in dental education: ChatGPT's performance on the periodontic in‐service examination. J Periodontol. 2024. Epub ahead of print. doi: 10.1002/JPER.23-0514. 38197146 · DOI
- [30]Freire Y, Santamaría Laorden A, Orejas Pérez J, Gómez Sánchez M, Díaz‐Flores García V, Suárez A. ChatGPT performance in prosthodontics: assessment of accuracy and repeatability in answer generation. J Prosthet Dent. 2024; 131: 659.e1‐ 659.e6. 38310063
- [31]Brown T, Mann B, Ryder N, et al. Language models are few‐shot learners. Adv Neural Inf Process Syst. 2020; 33: 1877‐ 1901.
Cited by
Sorted by citations
Urban, M., Brom, C., Lukavský, J., Děchtěrenko, F., Hein, V., Svacha, F., Kmoníčková, P., & Urban, K. (2025) · British Journal of Educational Technology · doi:10.1111/bjet.13591 · Cited by 47 · see citing works
Lin, Y., Luo, Z., Ye, Z., Zhong, N., Zhao, L., Zhang, L., Li, X., Chen, Z., & Chen, Y. (2025) · JMIR Medical Education · doi:10.2196/71125 · Cited by 31 · see citing works
“This inconsistency is particularly evident in complex case analyses [71,90,119,120].”
Ayanda, A. O. (2026) · International Journal of Applied Resilience and Sustainability · doi:10.70593/deepsci.0203003
“Explainable AI practices are designed to make the transparency more comprehensible, so that teachers, students, and school leaders are in a better position to understand how a model arrived at a specific recommendation or decision [31,33-35].”
- Authors
- Sabri, H., Saleh, M. H. A., Hazrati, P., Merchant, K., Misch, J., Kumar, P. S., Wang, H., & Barootchi, S.
- Affiliations
- University of Michigan (US)
- Naval Post‐Graduate Dental School Bethesda Maryland USA
- Harvard University (US)
- Corresponding author
- Sabri, Hamoun
- Barootchi, Shayan
- ORCID
- Venue
- Journal of Periodontal Research
- Publisher
- Wiley
- Published
- 2024-07-18
- Volume
- 60
- Issue
- 2
- Pages
- 121-133
- ISSN
- 0022-3484 (ISSN-L)
- 1600-0765
- PMC
- PMC11873669
- OpenAlex
- W4400838583
- Cited by
- 71
- References
- 6
- Citations by year
- 2026: 34 · 2025: 30 · 2024: 7
- FWCI
- 6.64
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Periodontal Research (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Physical Sciences › Computer Science › Information Systems › Artificial Intelligence in Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Keywords
- large language models, ChatGPT, Google Gemini, GPT-3.5, periodontal education, standardized testing, in-service examination, American Academy of Periodontology, ChatGPT-4, ChatGPT-3.5
- MeSH terms
- Large Language Models, Artificial Intelligence, Cross-Sectional Studies, Education, Dental, Educational Measurement, Humans, Language, Periodontics
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review