Inverted Maxillary Third Molar Impaction: Exploring Capabilities of Artificial Intelligence (AI) Versus Human Intelligence (HI) Expertise in Diagnosis and Treatment Planning
Authors: SA* Azim , MSR Tippu , HF Khairi , MT Dawood , MS Abdullah , NA Al-yasiri , OM Shawky , LA Muthiah , M Ali 
Published: August 2024

Introduction: The third molar is frequently affected in the oral cavity, with rare cases of inverted impaction in the maxillary region. This rarity poses unique challenges in diagnosis, treatment planning, and surgical procedures, with potential complications like sinusitis or infection. Current literature highlights a divide between conservative and surgical management, lacking comprehensive guidelines and exploring the role of AI-assisted tools. This study addresses this gap by evaluating the diagnostic accuracy of AI tools, particularly ChatGPT, against human specialists in Oral and Maxillofacial Surgery. Considering the growing role of AI in medicine, this research aims to provide insights into the potential of AI in enhancing diagnosis and treatment planning for rare cases, emphasizing collaboration between AI systems and medical professionals. Objectives: • Evaluate the diagnostic accuracy of AI tools (ChatGPT) compared to human-generated (specialist OMFS) diagnoses in dental cases. • Assess the efficiency and reliability of AI-assisted treatment plans in contrast to those generated by dental professionals. • Compare the performance and features of paid and non-paid versions of the AI programs utilized. Materials and Methods: This study centered on the unique case of a 59-year-old woman at Thumbay Dental Hospital, presenting issues related to a faulty dental bridge and a history of managed hypertension. An orthopantomogram showed the inverted impacted maxillary third molar Figure 1. The patient exhibited no direct symptoms from this impaction. A cone computed tomography was performed for a detailed analysis of the patient for complete prosthetic rehabilitation and academic purposes Figure 2. All the available data, including the history, clinical examination, and radiographic findings, were provided to a specialist and AI tools (ChatGPT version 3 and ChatGPT version 4) to get a diagnosis and treatment plan for this unusual case of an impacted third molar. Data collection comprised clinical examinations, imaging, and AI outputs, focusing on the accuracy of diagnostic and treatment plans. The study also assessed AI’s adaptability, cultural sensitivity, and practicality in clinical settings, aiming to gauge AI tools’ potential in enhancing dental diagnostics and treatment planning alongside human expertise. AI tools, including ChatGPT and its advanced versions, were employed to generate and compare diagnostic assessments and treatment plans against those created by dental professionals. Results: In a rare dental case involving a 59-year-old woman with a faulty dental bridge and managed hypertension, specialists at Thumbay Dental Hospital identified functional issues and an inverted impacted maxillary third molar using orthopantomogram and Cone Beam Computed Tomography. Collaborating with oral and maxillofacial surgeons, a comprehensive treatment plan for complete oral rehabilitation was formulated, considering age, anatomical complexity, and medical history, offering two options for the impacted third molar. The AI-generated diagnosis and treatment plans from ChatGPT versions 3 and 4 were explored. ChatGPT-3 provided a detailed plan for bridge replacement, including a specialized segment for managing the impacted third molar. ChatGPT-4 crafted a comprehensive plan starting with an initial consultation, encompassing diagnostic procedures, discussions on bridge replacement options, preparation, fabrication, fitting, and post-procedure care. The plan addressed missing teeth and the impacted tooth, highlighting adaptability to individual needs. However, ChatGPT-4 emphasized its inability to provide medical diagnoses, stressing the importance of professional evaluation. In summary, the study compares human-generated and AI-generated diagnosis and treatment plans. The human-generated plan prioritizes collaboration and comprehensive care, while AI-generated plans from ChatGPT versions 3 and 4 demonstrate detailed and adaptable approaches. ChatGPT-4 underscores the need for professional evaluation. The research sheds light on the potential roles of human and AI expertise in dental diagnostics and treatment planning, emphasizing the importance of collaboration for optimal patient care. Conclusion: This study highlights the collaborative potential of AI and human intelligence in handling intricate dental cases, such as Inverted Maxillary Third Molar Impaction. While AI tools like ChatGPT showcase the ability to create detailed treatment plans, their incapacity to replicate nuanced clinical judgment underscores the vital role of human oversight, particularly in specialized fields like Oral and Maxillofacial Surgery. The results are consistent with existing research, emphasizing AI as a supplement to, rather than a substitute for, human expertise in healthcare. The ongoing integration of AI with human medical practice shows promise in improving diagnostic accuracy and treatment effectiveness in dental healthcare.