Journals / Journal of Medicine and Palliative Care / 2026 / Volume: 7 Issue: 5

Evaluation of Demirjian-based dental age estimation: a comparison of multimodal large language models with specialist dentists

Banu Çiçek Tez Yaşar(ANKARA MEDİPOL ÜNİVERSİTESİ)0000-0002-6053-5547
Elif Gökçe Erkan Acar(ANKARA MEDİPOL ÜNİVERSİTESİ)0000-0002-7505-9125
Pages
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Publication Date
2026-10-25
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Current multimodal LLMs remain insufficiently accurate and consistent to replace specialist dentists and should be considered adjunctive decision-support tools.

📌 3 Key Takeaways

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Objective & Hypothesis:Aims: This study evaluated the performance of three multimodal large language models (LLMs) ChatGPT, Gemini, and Claude in Demirjian-based dental age (DA) estimation from panoramic radiographs compared with specialist dentists.
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Key Findings & Data:Methods: This retrospective cross-sectional study included 135 panoramic radiographs of children aged 6–13 years.
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Conclusion & Impact:Current multimodal LLMs remain insufficiently accurate and consistent to replace specialist dentists and should be considered adjunctive decision-support tools.
🔬Design:Modeling & Simulation
📍Scope:Comprehensive Sample
⚙️Variables:Artificial Intelligence · age determination by teeth · generative Artificial Intelligence

Abstract

Aims: This study evaluated the performance of three multimodal large language models (LLMs) ChatGPT, Gemini, and Claude in Demirjian-based dental age (DA) estimation from panoramic radiographs compared with specialist dentists. Methods: This retrospective cross-sectional study included 135 panoramic radiographs of children aged 6–13 years. Two specialist dentists confirmed inter-examiner reliability (ICC=0.90) on a pilot subset; the pediatric dentist then assessed all radiographs using the Demirjian method. The radiographs were analyzed once per model using standardized prompts in ChatGPT-5.5 Instant, Gemini 3.5 Flash, and Claude Sonnet 4.6; thus, the reported metrics reflect single-session model performance. Demirjian stages were converted into gender-specific maturity scores and DAs. Performance was assessed using bias, mean absolute error (MAE), and intraclass correlation coefficient (ICC). Statistical analyses included paired-samples t-tests, Wilcoxon, Friedman, Mann–Whitney U, and independent-samples t-tests (p 0.05). Conclusion: ChatGPT yielded the lowest MAE relative to CA; Gemini showed the highest specialist agreement, which should not be equated with accuracy. Current multimodal LLMs remain insufficiently accurate and consistent to replace specialist dentists and should be considered adjunctive decision-support tools.

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Cite This Article

Yaşar, B. Ç. T., Acar, E. G. E. (2026). Evaluation of Demirjian-based dental age estimation: a comparison of multimodal large language models with specialist dentists. Journal of Medicine and Palliative Care, Volume: 7 Issue: 5. https://ajindex.com/articles/1668081

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