Evaluating ChatGPT-4o, Gemini and Claude 3.7 in Endodontic Diagnostics: A Prospective Clinical Study
Conditions: Endodontic Diagnosis, Endodontic Diseases, Endodontic Treatment, Endodontic Decision-making
Sponsor: Marmara University

Evaluat'ng ChatGPT-4o, Gem'n' and Claude 3.7 'n Endodont'c D'agnost'cs:  
A Prospect've Cl'n'cal Study  
NCT number: not appl'cable 
Ethical Approval: Date: 26.06.2025, Protocol No: 2025-07-02/38 
Record Release Date/T'me: November 24, 2025 14:03 
Last Updated: December 8, 2025 
 
 

Study protocol 
Th#s observat#onal study evaluated the d#agnost#c and treatment-plann#ng performance of three 
large language models (LLMs)—ChatGPT-4o, Claude 3.7 Sonnet, and Gem#n# Advanced— 
us#ng real cl#n#cal cases collected from 120 pat#ents who presented to an endodont#c cl#n#c. For 
each pat#ent, a standard#zed case f#le was prepared that #ncluded demograph#c #nformat#on, 
deta#led med#cal and dental h#story, cl#n#cal f#nd#ngs (pa#n character#st#cs, percuss#on/palpat#on 
sens#t#v#ty, v#tal#ty test#ng, per#odontal status, s#nus tract presence, d#scolorat#on), and a 
per#ap#cal rad#ograph. All #nformat#on was anonym#zed and presented #n an #dent#cal, f#xed 
order to all models.  
Each LLM rece#ved the same s#ngle prompt (“Determ#ne the d#agnos#s and propose the 
appropr#ate treatment plan”) and the same case structure. Rad#ographs were uploaded as 
or#g#nal-resolut#on JPEG f#les through each platform’s nat#ve mult#modal #nterface. Text was 
entered f#rst, followed by the #mage upload. ChatGPT-4o, Gem#n# Advanced, and Claude 3.7 
were all used #n the#r default mult#modal conf#gurat#ons w#th no web-brows#ng, plug-#ns, 
external retr#eval tools, OCR, or f#ne-tun#ng enabled. “Search w#th Gem#n#” was manually 
d#sabled.  
Each case was subm#tted to the LLMs us#ng newly created accounts, accessed v#a Google 
Chrome on a desktop computer. All quest#ons were del#vered w#th#n a 24-hour w#ndow and #n 
the same predeterm#ned order. No pre-test#ng, prompt eng#neer#ng, or clar#fy#ng follow-up 
messages were allowed. If a model requested add#t#onal #nformat#on, no further #nput was g#ven. 
Each model generated only one response per case, reflect#ng real-world f#rst-response 
performance.  
To avo#d contextual contam#nat#on, each case was entered #n a separate chat sess#on w#th cleared 
conversat#on h#story. All outputs were recorded verbat#m and saved #n Word format. A panel of 

three #ndependent endodont#c spec#al#sts establ#shed the gold-standard d#agnoses and treatment 
plans for all cases. D#sagreements were resolved by consensus. AI responses were coded as “1” 
(cons#stent w#th gold standard) or “0” (#ncons#stent).