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Large Language Models and Retrieval-Augmented Platforms for the Diagnosis and Management of Periodontal Diseases: A Blinded Expert-Rated Comparative Study of 11 Systems.

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Τίτλος: Large Language Models and Retrieval-Augmented Platforms for the Diagnosis and Management of Periodontal Diseases: A Blinded Expert-Rated Comparative Study of 11 Systems.
Συγγραφείς: Mayer Y; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.; Department of Periodontology, Rambam Health Care Campus, Haifa, Israel., Demetriou B; Department of Periodontology, Rambam Health Care Campus, Haifa, Israel., Rasperini G; Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy., Gabay E; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.; Department of Periodontology, Rambam Health Care Campus, Haifa, Israel., Gašperšič R; Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia., Božić D; Department of Periodontology, School of Dental Medicine, University of Zagreb, Zagreb, Croatia., Calatrava J; Section of Graduate Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.; Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA., Ginesin O; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.; Department of Periodontology, Rambam Health Care Campus, Haifa, Israel., Giladi HZ; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.; Department of Periodontology, Rambam Health Care Campus, Haifa, Israel., Almeida RF; LAQV/REQUIMTE, Periodontology, Oral Surgery and Oral Medicine Department, Faculty of Dental Medicine, University of Porto, Porto, Portugal.
Πηγή: Journal of clinical periodontology [J Clin Periodontol] 2026 Oct; Vol. 53 (10), pp. 1546-1556. Date of Electronic Publication: 2026 Jul 05.
Τύπος έκδοσης: Journal Article; Comparative Study
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Wiley-Blackwell Country of Publication: United States NLM ID: 0425123 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1600-051X (Electronic) Linking ISSN: 03036979 NLM ISO Abbreviation: J Clin Periodontol Subsets: MEDLINE
Imprint Name(s): Publication: Malden, MA : Wiley-Blackwell
Original Publication: Copenhagen, Munksgaard.
Ιατρικοί όροι (MeSH): Periodontal Diseases*/diagnosis , Periodontal Diseases*/therapy , Large Language Models* , Information Storage and Retrieval*, Humans ; Generative Artificial Intelligence
Περίληψη: Aim: To compare retrieval-augmented systems with general-purpose large language models (LLMs) on standardised periodontal clinical vignettes.
Materials and Methods: Eleven AI systems were evaluated: nine general-purpose LLMs, one general-purpose retrieval-augmented platform (Perplexity) and one medical-domain retrieval-augmented platform (OpenEvidence). Each responded to 30 synthetic vignettes covering acute, chronic and complex periodontal scenarios. Six blinded periodontists scored responses on a 5-point Likert scale for accuracy, safety, freedom from hallucinations and completeness in a randomised block design. Friedman and Conover-Iman tests with Holm correction were applied; mixed-effects and ordinal models served as sensitivity analyses.
Results: At least one parameter scored dangerous (≤ 2) in 3.3%-46.7% of responses across platforms, despite mean composite scores (3.28-4.86) exceeding the rubric midpoint of 3.0. Between-model differences were significant (p < 0.001), with a small-to-medium overall effect (Kendall's W = 0.17) and large within-category effects (W up to 0.82). Perplexity, OpenEvidence and Claude 4.7 Opus formed a top tier.
Conclusion: Retrieval-augmented systems rated highest, but this advantage was confounded with response length. The dangerous-response spread argues against undifferentiated use. These tools should assist, not replace, specialist judgement.
(© 2026 The Author(s). Journal of Clinical Periodontology published by John Wiley & Sons Ltd.)
References: Nat Med. 2025 Jan;31(1):60-69. (PMID: 39779929)
J Dent Res. 2014 Nov;93(11):1045-53. (PMID: 25261053)
JAMA Netw Open. 2026 Apr 01;9(4):e264003. (PMID: 41973425)
J Periodontal Res. 2025 Feb;60(2):121-133. (PMID: 39030766)
Commun Med (Lond). 2025 Aug 2;5(1):330. (PMID: 40753316)
J Clin Periodontol. 2018 Jun;45 Suppl 20:S219-S229. (PMID: 29926500)
J Clin Periodontol. 2025 May;52(5):707-716. (PMID: 39723544)
Clin Oral Investig. 2024 Jun 29;28(7):407. (PMID: 38951256)
J Clin Periodontol. 2020 Jul;47 Suppl 22:4-60. (PMID: 32383274)
Nat Med. 2023 Aug;29(8):1930-1940. (PMID: 37460753)
Front Digit Health. 2026 Jan 05;7:1687820. (PMID: 41561161)
J Periodontol. 2018 Jun;89 Suppl 1:S159-S172. (PMID: 29926952)
J Clin Periodontol. 2018 Jun;45 Suppl 20:S1-S8. (PMID: 29926489)
J Am Med Inform Assoc. 2025 Apr 1;32(4):605-615. (PMID: 39812777)
Dent J (Basel). 2025 Jun 21;13(7):. (PMID: 40710124)
Med Sci Monit. 2026 Apr 01;32:e951721. (PMID: 41920800)
Dent J (Basel). 2025 Jun 18;13(6):. (PMID: 40559174)
J Am Dent Assoc. 2018 Jul;149(7):576-588.e6. (PMID: 29957185)
J Chiropr Med. 2016 Jun;15(2):155-63. (PMID: 27330520)
Interact J Med Res. 2025 Jan 28;14:e59823. (PMID: 39874574)
J Clin Periodontol. 2022 Aug;49(8):732-739. (PMID: 35322458)
J Periodontol. 2018 Jun;89 Suppl 1:S173-S182. (PMID: 29926951)
J Clin Periodontol. 2022 Jun;49 Suppl 24:4-71. (PMID: 35688447)
BMC Bioinformatics. 2017 Jan 25;18(1):68. (PMID: 28122501)
J Prosthet Dent. 2025 Dec;134(6):2435-2442. (PMID: 40055086)
J Periodontol. 2018 Jun;89 Suppl 1:S85-S102. (PMID: 29926942)
J Prosthet Dent. 2025 Dec;134(6):2328-2336. (PMID: 39562221)
Lancet. 2019 Jul 20;394(10194):249-260. (PMID: 31327369)
BDJ Open. 2024 Dec 1;10(1):90. (PMID: 39617779)
Contributed Indexing: Keywords: artificial intelligence; clinical decision support; diagnosis; large language models; periodontitis
Entry Date(s): Date Created: 20260705 Date Completed: 20260916 Latest Revision: 20260919
Update Code: 20260919
PubMed Central ID: PMC13581464
DOI: 10.1111/jcpe.70160
PMID: 42402252
Βάση Δεδομένων: MEDLINE
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  Data: Large Language Models and Retrieval-Augmented Platforms for the Diagnosis and Management of Periodontal Diseases: A Blinded Expert-Rated Comparative Study of 11 Systems.
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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Mayer+Y%22&quot;&gt;Mayer Y&lt;/searchLink&gt;; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.; Department of Periodontology, Rambam Health Care Campus, Haifa, Israel.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Demetriou+B%22&quot;&gt;Demetriou B&lt;/searchLink&gt;; Department of Periodontology, Rambam Health Care Campus, Haifa, Israel.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Rasperini+G%22&quot;&gt;Rasperini G&lt;/searchLink&gt;; Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Gabay+E%22&quot;&gt;Gabay E&lt;/searchLink&gt;; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.; Department of Periodontology, Rambam Health Care Campus, Haifa, Israel.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Gašperšič+R%22&quot;&gt;Gašperšič R&lt;/searchLink&gt;; Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Božić+D%22&quot;&gt;Božić D&lt;/searchLink&gt;; Department of Periodontology, School of Dental Medicine, University of Zagreb, Zagreb, Croatia.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Calatrava+J%22&quot;&gt;Calatrava J&lt;/searchLink&gt;; Section of Graduate Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.; Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Ginesin+O%22&quot;&gt;Ginesin O&lt;/searchLink&gt;; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.; Department of Periodontology, Rambam Health Care Campus, Haifa, Israel.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Giladi+HZ%22&quot;&gt;Giladi HZ&lt;/searchLink&gt;; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.; Department of Periodontology, Rambam Health Care Campus, Haifa, Israel.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Almeida+RF%22&quot;&gt;Almeida RF&lt;/searchLink&gt;; LAQV/REQUIMTE, Periodontology, Oral Surgery and Oral Medicine Department, Faculty of Dental Medicine, University of Porto, Porto, Portugal.
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  Data: Aim: To compare retrieval-augmented systems with general-purpose large language models (LLMs) on standardised periodontal clinical vignettes.&lt;br /&gt;Materials and Methods: Eleven AI systems were evaluated: nine general-purpose LLMs, one general-purpose retrieval-augmented platform (Perplexity) and one medical-domain retrieval-augmented platform (OpenEvidence). Each responded to 30 synthetic vignettes covering acute, chronic and complex periodontal scenarios. Six blinded periodontists scored responses on a 5-point Likert scale for accuracy, safety, freedom from hallucinations and completeness in a randomised block design. Friedman and Conover-Iman tests with Holm correction were applied; mixed-effects and ordinal models served as sensitivity analyses.&lt;br /&gt;Results: At least one parameter scored dangerous (≤ 2) in 3.3%-46.7% of responses across platforms, despite mean composite scores (3.28-4.86) exceeding the rubric midpoint of 3.0. Between-model differences were significant (p &amp;lt; 0.001), with a small-to-medium overall effect (Kendall&#39;s W = 0.17) and large within-category effects (W up to 0.82). Perplexity, OpenEvidence and Claude 4.7 Opus formed a top tier.&lt;br /&gt;Conclusion: Retrieval-augmented systems rated highest, but this advantage was confounded with response length. The dangerous-response spread argues against undifferentiated use. These tools should assist, not replace, specialist judgement.&lt;br /&gt; (&#169; 2026 The Author(s). Journal of Clinical Periodontology published by John Wiley &amp; Sons Ltd.)
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  Data: Nat Med. 2025 Jan;31(1):60-69. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2239779929%22&quot;&gt;39779929)&lt;/searchLink&gt;&lt;br /&gt;J Dent Res. 2014 Nov;93(11):1045-53. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2225261053%22&quot;&gt;25261053)&lt;/searchLink&gt;&lt;br /&gt;JAMA Netw Open. 2026 Apr 01;9(4):e264003. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2241973425%22&quot;&gt;41973425)&lt;/searchLink&gt;&lt;br /&gt;J Periodontal Res. 2025 Feb;60(2):121-133. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2239030766%22&quot;&gt;39030766)&lt;/searchLink&gt;&lt;br /&gt;Commun Med (Lond). 2025 Aug 2;5(1):330. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2240753316%22&quot;&gt;40753316)&lt;/searchLink&gt;&lt;br /&gt;J Clin Periodontol. 2018 Jun;45 Suppl 20:S219-S229. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2229926500%22&quot;&gt;29926500)&lt;/searchLink&gt;&lt;br /&gt;J Clin Periodontol. 2025 May;52(5):707-716. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2239723544%22&quot;&gt;39723544)&lt;/searchLink&gt;&lt;br /&gt;Clin Oral Investig. 2024 Jun 29;28(7):407. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2238951256%22&quot;&gt;38951256)&lt;/searchLink&gt;&lt;br /&gt;J Clin Periodontol. 2020 Jul;47 Suppl 22:4-60. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2232383274%22&quot;&gt;32383274)&lt;/searchLink&gt;&lt;br /&gt;Nat Med. 2023 Aug;29(8):1930-1940. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2237460753%22&quot;&gt;37460753)&lt;/searchLink&gt;&lt;br /&gt;Front Digit Health. 2026 Jan 05;7:1687820. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2241561161%22&quot;&gt;41561161)&lt;/searchLink&gt;&lt;br /&gt;J Periodontol. 2018 Jun;89 Suppl 1:S159-S172. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2229926952%22&quot;&gt;29926952)&lt;/searchLink&gt;&lt;br /&gt;J Clin Periodontol. 2018 Jun;45 Suppl 20:S1-S8. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2229926489%22&quot;&gt;29926489)&lt;/searchLink&gt;&lt;br /&gt;J Am Med Inform Assoc. 2025 Apr 1;32(4):605-615. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2239812777%22&quot;&gt;39812777)&lt;/searchLink&gt;&lt;br /&gt;Dent J (Basel). 2025 Jun 21;13(7):. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2240710124%22&quot;&gt;40710124)&lt;/searchLink&gt;&lt;br /&gt;Med Sci Monit. 2026 Apr 01;32:e951721. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2241920800%22&quot;&gt;41920800)&lt;/searchLink&gt;&lt;br /&gt;Dent J (Basel). 2025 Jun 18;13(6):. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2240559174%22&quot;&gt;40559174)&lt;/searchLink&gt;&lt;br /&gt;J Am Dent Assoc. 2018 Jul;149(7):576-588.e6. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2229957185%22&quot;&gt;29957185)&lt;/searchLink&gt;&lt;br /&gt;J Chiropr Med. 2016 Jun;15(2):155-63. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2227330520%22&quot;&gt;27330520)&lt;/searchLink&gt;&lt;br /&gt;Interact J Med Res. 2025 Jan 28;14:e59823. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2239874574%22&quot;&gt;39874574)&lt;/searchLink&gt;&lt;br /&gt;J Clin Periodontol. 2022 Aug;49(8):732-739. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2235322458%22&quot;&gt;35322458)&lt;/searchLink&gt;&lt;br /&gt;J Periodontol. 2018 Jun;89 Suppl 1:S173-S182. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2229926951%22&quot;&gt;29926951)&lt;/searchLink&gt;&lt;br /&gt;J Clin Periodontol. 2022 Jun;49 Suppl 24:4-71. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2235688447%22&quot;&gt;35688447)&lt;/searchLink&gt;&lt;br /&gt;BMC Bioinformatics. 2017 Jan 25;18(1):68. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2228122501%22&quot;&gt;28122501)&lt;/searchLink&gt;&lt;br /&gt;J Prosthet Dent. 2025 Dec;134(6):2435-2442. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2240055086%22&quot;&gt;40055086)&lt;/searchLink&gt;&lt;br /&gt;J Periodontol. 2018 Jun;89 Suppl 1:S85-S102. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2229926942%22&quot;&gt;29926942)&lt;/searchLink&gt;&lt;br /&gt;J Prosthet Dent. 2025 Dec;134(6):2328-2336. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2239562221%22&quot;&gt;39562221)&lt;/searchLink&gt;&lt;br /&gt;Lancet. 2019 Jul 20;394(10194):249-260. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2231327369%22&quot;&gt;31327369)&lt;/searchLink&gt;&lt;br /&gt;BDJ Open. 2024 Dec 1;10(1):90. (PMID: &lt;searchLink fieldCode=&quot;PM&quot; term=&quot;%2239617779%22&quot;&gt;39617779)&lt;/searchLink&gt;
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              Y: 2026
          Identifiers:
            – Type: issn-electronic
              Value: 1600-051X
          Numbering:
            – Type: volume
              Value: 53
            – Type: issue
              Value: 10
          Titles:
            – TitleFull: Journal of clinical periodontology
              Type: main
ResultId 1