Imaging · #1 (tied) of 13

Pearl (Second Opinion)

Pearl's Second Opinion is FDA-cleared radiograph AI built for the chairside conversation, with the widest product suite of any imaging tool we rank.

Editorial score

FDA-cleared AI radiograph detection for chairside case acceptance, plus Pearl Voice ambient notes and voice perio charting (launched April 2026).

Category rank: #1 (tied) of 13 in Imaging
Confidence: High (85%)
Last reviewed: October 15, 2026

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How we scored it

Criterion	Weight	Score
Regulatory evidence FDA-cleared Second Opinion (K210365, 2022) plus a pediatric clearance (K243893, 2025).	30%	9.5
Detection scope Cleared to flag caries, calculus, margin discrepancies, periapical radiolucency and restorations; vendor also offers CBCT review.	20%	9.0
Imaging & PMS integrations Vendor lists 40+ integrations with imaging and practice management systems.	20%	9.0
Chairside patient communication Built around chairside color overlays and patient reports; 30% acceptance lift is vendor-reported.	15%	9.0
Scale & support Vendor reports 29,000+ practices and DSO customers; we haven't verified support quality independently.	15%	7.5

Weighted result 8.9. Last reviewed Oct 17, 2026. How we score · Request a score review

Pricing

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Not published by the vendor. We only list prices vendors publish.

Works with

ArchyListed partner source
CareStackListed partner source
DenticonListed partner source
Dentrix AscendListed partner source
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Open DentalListed partner source
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From Pearl (Second Opinion)'s own integration pages and docs, checked by our team. Integrated means two-way sync or write-back; listed partner means named without stated depth. Confirm your exact version with the vendor.

Our review

Pearl's core product, Second Opinion, reads bitewing and periapical x-rays and marks suspected findings for the clinician. Its FDA clearance (K210365, March 2022) covers caries, calculus, margin discrepancies, periapical radiolucency and existing restorations such as crowns, fillings, root canals, bridges and implants, for patients 12 and older. A pediatric version (K243893) was cleared in 2025 for patients as young as 4. Pearl also sells Second Opinion 3D for CBCT review, plus Practice Intelligence analytics, an RCM product, a clinical training tool (Calibrate) and Pearl Voice. Launched in April 2026, Pearl Voice turns chairside conversations into structured SOAP notes, charts perio measurements by voice in real time, and writes notes back to the PMS.

Pearl says it has 40+ integrations with imaging and practice management systems and more than 29,000 practices. It reports a 30% lift in treatment acceptance. That figure is vendor-reported; we haven't verified it.

Who it's for: practices whose biggest gap is case acceptance, from single offices to DSOs that want consistent diagnostic criteria across providers.

Watch-outs: pricing isn't published. Ask whether you're quoted per location, per provider or per module, and confirm your exact imaging system is supported before the demo. Decide who reviews the AI findings each day so the overlays help instead of becoming noise.

Our take: tied for the top imaging score (8.8) because the FDA evidence, detection scope and patient-facing design are all strong.

Sources (5)

Compare Pearl (Second Opinion)

Pearl (Second Opinion) vs Overjet

Other Imaging tools

OverjetFDA-cleared AI for x-ray detection and quantification, popular with DSOs.8.8
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DentalMonitoringFDA De Novo-authorized AI remote monitoring for orthodontic treatment from smartphone scans.8.0

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