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Pearl AI Overview

Josh Grabia
Updated

Pearl Second Opinion® – Denticon / Apteryx Overview

Overview

Second Opinion® is Pearl’s FDA‑cleared AI for radiologic analysis. It is designed to highlight areas of interest directly on dental x‑rays within your Apteryx imaging workflow.

Second Opinion serves as a second set of eyes, not a replacement for clinical judgment. It helps providers detect, review, and communicate findings with greater consistency across patients, providers, and visits.

Second Opinion runs automatically in the background and flags detections using clear, color‑coded visual markers.

What Pearl Second Opinion Detects

Second Opinion can highlight the following findings on supported radiographs:

  • Caries
    • Incipient lesions
    • Progressed decay
  • Calculus
  • Marginal discrepancies
  • Periapical radiolucencies
  • Restorations
  • Root canals (previously treated systems)
  • Bone levels
    • Measures the distance from the cementoenamel junction (CEJ) to the alveolar crest (in millimeters)

How Findings Are Displayed

AI overlays appear directly on each radiograph in Apteryx. Each finding type is displayed using a distinct color or shape for easy identification.

Finding Visual Indicator
Caries – Incipient Yellow
Caries – Progressed Pink
Calculus Green box
Notable margins Purple box
Periapical radiolucency Blue
Bone level measurements Green: 0–2.5 mm
Yellow: 2.5–4 mm
Orange: 4 mm+

Supported Image Types

Second Opinion analyzes the following image types:

  • Bitewings and periapicals
    • Supported for all patients age 4 and older
  • Panoramic images
    • Supported for patients age 16 and older

Supported image types may vary slightly by integration.

Additional Features

Tooth Part Mapping

Displays a patient’s unique oral anatomy directly on the radiograph, helping visualize tooth structure and segmentation.

Detection Editor

Allows users to control which AI findings are visible during case review or presentation.

Image Enhancement Tools

Adjust clarity and contrast to improve radiograph visibility during review and presentation.

FMX Auto‑Layout

Access full mouth series images in an intuitive grid view for efficient navigation and comparison.

AI Viewer

Toggle AI overlays on or off to review the original radiograph, and use the sidebar to filter and favorite specific findings or tooth parts.

Bone Level Measurements

Second Opinion’s bone level feature measures the distance from the cementoenamel junction (CEJ) to the alveolar crest on visible interproximal surfaces. Measurements are displayed in millimeters.

These measurements provide support for periodontal assessment by showing a radiographic snapshot of bone height at the time the image was captured. This feature does not replace periodontal charting or probing depth assessments.

Bone Level Color Indicators

  • Green (0–2.5 mm): Within normal range
  • Yellow (2.5–4 mm): Moderate bone loss
  • Orange (4 mm+): Significant bone loss

FDA / Regulatory Information

Pearl Second Opinion® is FDA‑cleared for use on patients ages 4 and older and is intended for use by the full clinical dental team.

Second Opinion received 510(k) clearance in May 2025.

Cleared indications include:

  • Caries detection
  • Calculus detection
  • Periapical radiolucencies
  • Bone level measurements
  • Fillings, crowns, root canal treatments, implants
  • Tooth part segmentation
  • Bridges
  • 3D segmentation

Frequently Asked Questions

Does my practice still need to perform periodontal probing?

Yes. Second Opinion estimates radiographic bone levels but does not interpret periodontal probing depths. Comprehensive periodontal probing and charting by a licensed dental professional remain essential for diagnosis and treatment planning.

Does Second Opinion® make diagnoses?

No.

Second Opinion® is an assistive radiologic tool, not a diagnostic device. It highlights areas of interest on dental radiographs using AI technology.

All diagnostic decisions must be made by a licensed dental healthcare professional using appropriate clinical judgment.

Why This Matters

Second Opinion® helps streamline radiograph review and supports:

  • Consistent detection
  • Improved patient education
  • Clearer case presentation

It enhances clinical workflows but does not replace clinical expertise or decision‑making.

How to Move Images to Another Patient

If x‑rays are uploaded under the wrong patient, Pearl Support can help reassign them.

Steps to Request an Image Move

  1. Navigate to the Pearl Support Request Form
  2. Provide the following details:
    • Current patient name
    • Correct patient name
    • Image type(s), date, and number of images (if available)
  3. Submit the form

Important Notes

  • For security and auditing purposes, image reassignment can only be performed by Pearl’s technical team
  • Typical processing time is 1–2 business days

Why Detection May Vary Between Similar Images

Pearl analyzes each image independently. Even small differences can impact AI detections.

Common Reasons

  • X‑ray angulation
  • Exposure and contrast
  • Image resolution

These variations mirror how human interpretation can differ between images. Second Opinion provides an additional perspective to support, not replace, clinical judgment.

Best Practices

  • Always compare AI findings with your clinical assessment
  • Use comparison views when available
  • Adjust image clarity and contrast for optimal review

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