Background Artificial intelligence (AI) language models have shown potential as educational tools in healthcare, but their accuracy and reliability in periodontology education require further evaluation. In this study we aimed to assess and compare the performance of three prominent AI language models—ChatGPT-4o, Claude 3 Opus, and Gemini Advanced—with second-year periodontics residents across the United States on the American Academy of Periodontology 2024 in-service examination.

Methods We conducted a cross-sectional study using 331 multiple-choice questions from the 2024 periodontology in-service examination. We evaluated and compared the performances of ChatGPT-4o, Claude 3 Opus, and Gemini Advanced across various question domains. The results of second-year periodontics residents served as a benchmark.

Results ChatGPT-4o, Gemini Advanced, and Claude 3 Opus significantly outperformed second-year periodontics residents across the United States, with accuracy rates of 92.7 percent, 81.6 percent, and 78.5 percent, respectively, compared to the residents’ 61.9 percent. The differences in performance among the AI models were statistically significant (p < 0.001). Percentile rankings underscored the superior performance of the AI models, with ChatGPT-4o, Gemini Advanced, and Claude 3 Opus placing in the 99.95th, 98th, and 95th percentiles, respectively.

Conclusion ChatGPT-4o displayed superior performance compared to Claude 3 Opus and Gemini Advanced. The results highlight the potential of AI large language models (LLMs) as educational tools in periodontology and emphasize the need for ongoing evaluation and validation as these technologies evolve. Researchers should explore both the integration of AI language models into periodontal education and their impact on learning outcomes and clinical decision-making.

The authors have declared no competing interest.

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes