# Assessing ChatGPT's Reliability in Endodontics: Implications for AI-Enhanced Clinical Learning
## 1 Introduction  
Artificial intelligence (AI) is a branch of computer science focused on developing machines capable of performing tasks in a human-like manner [1, 2]. Within AI, large language models (LLMs) are systems developed using deep learning algorithms, designed to process natural language and generate text-based responses [3]. These LLMs have undergone significant advancements over the past decade [4], with one of the best-known examples being the Chat Generative Pre-Trained Transformer (ChatGPT, OpenAI, San Francisco, CA, USA) [5, 6]. OpenAI has progressively developed various generative language models. For a better understanding of their evolution and characteristics, Table 1 summarizes the timeline of the most relevant versions, from GPT-1 to ChatGPT-4o, including the recent variants released in 2024. According to its developers, ChatGPT-4o represents a significant evolution over GPT-4. The new model enhances overall performance while optimizing efficiency and cost, making it well suited for scientific, industrial, and commercial applications. Its advancements are particularly notable in textual reasoning, encoding, and multilingual analysis, as well as in its integration of advanced tools for processing auditory and visual information [8]. Given these capabilities, ChatGPT and other similar LLMs have rapidly emerged as influential tools in the context of online education [9]. In e-learning environments, the integration of LLMs has transformed the way students and teachers interact with content. ChatGPT, for instance, has been used to enhance student engagement [10], generate personalized learning materials [11], and support teachers through automated feedback [12] and content design [13]. Although much of the existing research has focused on the clinical and diagnostic applications of ChatGPT in healthcare [14; 15; 16; 17; 18], including dentistry [19; 20; 21; 22; 23; 24; 25; 26], few studies have examined its effectiveness as an educational technology tool in the field of dentistry [27]. In the context of health sciences education--dental education, in particular--understanding how reliable and consistent ChatGPT is in generating accurate and repeatable responses is essential for its adoption in teaching scenarios. In dentistry, ChatGPT-4o outperformed ChatGPT-3.5 at the Japanese National Dental Examination [19]. However, ChatGPT-4 and ChatGPT-4o have shown similar reliability in generating BI-RADS scores in medicine [28]. Meanwhile, in restorative dentistry and endodontics, researchers found that ChatGPT-4o outperformed favorably to ChatGPT-4 in student assessments, though there was no significant difference between the two versions [29]. Therefore, investigating the role of ChatGPT in educational contexts--particularly in specialized domains such as endodontics--offers valuable insights into its potential as an AI-powered educational assistant. This aligns with the growing need to evaluate AI not merely as a technical solution, but as an integral component of digital pedagogy [30]. Understanding the reliability (accuracy) and repeatability (consistency) of ChatGPT's responses is essential to determining its value in learning activities, whether for self-directed study, formative assessment, or content exploration.