Abstract
Early diagnosis of oral lichen planus (OLP) is challenging, which traditionally is dependent on clinical experience and subjective interpretation. Artificial intelligence (AI) technology has been widely applied in objective and rapid diagnoses. In this study, we aim to investigate the potential of AI diagnosis in OLP and evaluate its effectiveness in improving diagnostic accuracy and accelerating clinical decision making. A total of 128 confirmed OLP patients were included, and lesion images from various anatomical sites were collected. The diagnosis was performed using AI platforms, including ChatGPT-4O, ChatGPT (Diagram-Date extension), and Claude Opus, for AI directly identification and AI pre-training identification. After OLP feature training, the diagnostic accuracy of the AI platforms significantly improved, with the overall recognition rates of ChatGPT-4O, ChatGPT (Diagram-Date extension), and Claude Opus increasing from 59%, 68%, and 15% to 77%, 80%, and 50%, respectively. Additionally, the pre-training recognition rates for buccal mucosa reached 94%, 93%, and 56%, respectively. However, the AI platforms performed less effectively when recognizing lesions in less common sites and complex cases; for instance, the pre-training recognition rates for the gums were only 60%, 60%, and 20%, demonstrating significant limitations. The study highlights the strengths and limitations of different AI technologies and provides a reference for future AI applications in oral medicine.