{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T12:53:50Z","timestamp":1791636830984,"version":"4.3.4"},"reference-count":44,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:00:00Z","timestamp":1791590400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:00:00Z","timestamp":1791590400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Dental Education"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Large language models (LLMs) can enhance learning engagement and accessibility, though their performance in dentistry is inconsistent. Bitewing radiographs are critical for caries detection but prone to diagnostic errors from operator positioning. This study compared the performance of four LLMs with reasoning capabilities, GPT o1, GPT o3\u2010mini, Gemini 2.0 Flash and Grok 3, in generating scenario\u2010specific educational feedback from a structured textual format of bitewing radiographs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Ten positioning error scenarios were created by DMFR specialists. LLMs were evaluated using an original prompt (OP) and an engineered prompt (EP), resulting in a 4\u2009\u00d7\u20092 LLM\u2010by\u2010prompt design. Each LLM was tested via its model\u2010specific access mode: API or web interface. Eighty outputs were assessed by two DMFR specialists for detail, content, clarity and relevance using a 5\u2010point Likert scale. Ordinal category\u2010level scores were analysed using a cumulative link mixed\u2010effects model, with LLM, prompt type, scenario group, assessment category and LLM\u2009\u00d7\u2009prompt as fixed effects, and scenario as a random intercept.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The LLM\u2013prompt interaction was significant, indicating prompt engineering affected models differently. GPT o3\u2010mini had significantly lower odds of higher scores than Gemini 2.0 Flash, while EP reduced Grok 3 performance. Positioning error type influenced performance, with significant model\u2010dependent differences across scenario groups. No significant LLM\u2013assessment category interaction was observed, suggesting model differences did not vary across assessment categories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>LLM\u2010generated feedback varied by model, prompt design and positioning error type, but not consistently across assessment categories. Outputs require validation, model\u2010specific prompt testing and specialist review before implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/eje.70325","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T10:10:20Z","timestamp":1791627020000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>AI<\/scp>\n                    \u2010Driven Feedback on Bitewing Radiographic Technique: A Comparative Study of Large Language Models"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2691-2863","authenticated-orcid":false,"given":"Katharina Alves","family":"Rabelo","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health Sydney Dental School, The University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4096-5491","authenticated-orcid":false,"given":"Laura","family":"Swinckles","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sydney Dental School, The University of Sydney  Sydney Australia"},{"name":"Department of Oral Public Health Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam  Amsterdam the Netherlands"},{"name":"Inholland University of Applied Sciences  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4866-1946","authenticated-orcid":false,"given":"Eduardo","family":"Delamare","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sydney Dental School, The University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuoran","family":"Duan","sequence":"additional","affiliation":[{"name":"Faculty of Engineering School of Computer Science, The University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7674-6468","authenticated-orcid":false,"given":"Elvis","family":"Trinh","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sydney Dental School, The University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5370-8342","authenticated-orcid":false,"given":"Yongpei","family":"Ma","sequence":"additional","affiliation":[{"name":"Faculty of Engineering School of Computer Science, The University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5960-1060","authenticated-orcid":false,"given":"Jinman","family":"Kim","sequence":"additional","affiliation":[{"name":"Faculty of Engineering School of Computer Science, The University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9892-1323","authenticated-orcid":false,"given":"Vesna","family":"Miletic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sydney Dental School, The University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,10]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"H.Naveed A. 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