{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:06:53Z","timestamp":1788930413926,"version":"build-2803163510"},"reference-count":82,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1R56DE033709-01"],"award-info":[{"award-number":["1R56DE033709-01"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"award":["1R56DE033709-01"],"award-info":[{"award-number":["1R56DE033709-01"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dent. J.","Dentistry Journal"],"abstract":"<jats:p>Objectives: The objectives of this study were as follows: (1) statistical investigation of the association between systemic diseases and dental pulp condition; and (2) utilization of locally running large language models (LLMs) to handle a large number of dental charts written in natural languages, while protecting patients\u2019 information. Methods: A total of 5820 endodontic charts, including healthy controls and patients with a history of cancer, HIV, type 1 diabetes mellitus (DM), and type 2 DM, were selected from 15,147 samples. Using a local LLM environment, the dental charts from each group were classified into six categories: normal pulp (NP); reversible pulpitis (RP); asymptomatic irreversible pulpitis (AIP); symptomatic irreversible pulpitis (SIP); pulp necrosis (PN); and \u201cothers\u201d, including unclear diagnoses. The distributions of these diagnoses across groups were statistically analyzed. Results: The prompt for the local LLM was repeatedly refined by classifying 400 test cases, resulting in 97.0% agreement with the judgments of three human dentists. The refined prompt was then applied to classify 5820 charts, followed by statistical analyses. Using a generalized linear mixed-effects model (GLMM), the cancer-history group showed a significantly higher NP and a lower AIP proportion, whereas the type 2 DM group showed a significantly lower AIP and a higher SIP proportion. Conclusions: The findings in the cancer-history group could be attributable to a worsened oral environment in the patients and difficulties in diagnosing AIP. Meanwhile, the lower proportion of AIP and higher proportion of SIP in type 2 DM group may reflect pulpal inflammation associated with the disease. Additional attention may be warranted for caries\u2019 prevention and treatment in patients with type 2 DM.<\/jats:p>","DOI":"10.3390\/dj14090575","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T16:30:02Z","timestamp":1788798602000},"page":"575","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations Between Systemic Diseases and Dental Pulp Diagnoses: A Retrospective Chart Study Using a Locally Deployed Large Language Model"],"prefix":"10.3390","volume":"14","author":[{"given":"Yoshifumi","family":"Kobayashi","sequence":"first","affiliation":[{"name":"Department of Oral Biology, Rutgers School of Dental Medicine, Newark, NJ 07103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2485-1892","authenticated-orcid":false,"given":"Shuying","family":"Jiang","sequence":"additional","affiliation":[{"name":"Academic Affairs, Rutgers School of Dental Medicine, Newark, NJ 07103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1277-6634","authenticated-orcid":false,"given":"Jia","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Oral Biology, Rutgers School of Dental Medicine, Newark, NJ 07103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tami","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Oral Biology, Rutgers School of Dental Medicine, Newark, NJ 07103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Roeder","sequence":"additional","affiliation":[{"name":"Department of Oral Biology, Rutgers School of Dental Medicine, Newark, NJ 07103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyaa","family":"Chen","sequence":"additional","affiliation":[{"name":"Office of Information Technology, Rutgers, The State University of New Jersey, Newark, NJ 07101, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nika S.","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Oral Biology, Rutgers School of Dental Medicine, Newark, NJ 07103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6242-6451","authenticated-orcid":false,"given":"Daniel H.","family":"Fine","sequence":"additional","affiliation":[{"name":"Department of Oral Biology, Rutgers School of Dental Medicine, Newark, NJ 07103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emi","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Oral Biology, Rutgers School of Dental Medicine, Newark, NJ 07103, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1111\/iej.13143","article-title":"Impact of systemic diseases and tooth-based factors on outcome of root canal treatment","volume":"52","author":"Laukkanen","year":"2019","journal-title":"Int. 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