The purpose of this observational methodological study is to evaluate whether large language models can transform structured dental radiology data into clear narrative radiology reports. Large language models are computer programs that can generate text from information provided to them. In this study, the input will consist of organized dental radiology findings, such as chart-style or diagram-based information about teeth and surrounding structures.

Dental radiology reports are used by dentists and other health care providers to understand imaging findings and support clinical documentation. Preparing narrative reports may be time-consuming, and the wording of reports may vary between clinicians. This study will examine whether language-model-assisted report generation can produce reports that are complete, accurate, understandable, and clinically useful.

The study will compare reports generated with support from large language models with traditionally prepared reports. Researchers will also assess how the wording of the prompt and selected model parameters influence report quality. In addition, the study will analyze errors and safety risks in generated reports and evaluate whether such a system could be practical in a dental radiology workflow. The language model will not make treatment decisions, and generated reports will be used for research evaluation only.

This study is designed to evaluate the use of large language models for converting structured dental radiology data into narrative radiology reports. The project focuses on the quality, safety, and practical usability of language-model-assisted report generation in dental radiology.

Structured dental radiology data will be used as the input for the language model. These data may include organized findings recorded in a diagram, chart, or predefined structured format. The model will be asked to transform this structured information into a narrative report resembling a conventional dental radiology description. The study does not evaluate the model as an autonomous diagnostic system. The model will not independently interpret radiographic images, establish a diagnosis, or recommend treatment. Its role is limited to generating narrative text from already structured radiological information.

The study will include several related analyses. First, the investigators will assess whether a large language model can reliably transform structured dental radiology findings into a narrative report. Generated reports will be evaluated for completeness, factual consistency with the source data, clarity, terminology, and clinical readability.

Second, the study will examine how prompt construction and model parameters affect the quality of the generated reports. Different prompt formats and selected generation settings may be compared to identify configurations associated with higher report quality and fewer errors.

Third, reports generated with model assistance will be compared with traditionally prepared narrative reports. The comparison may include blinded assessment by qualified evaluators, who will judge report quality without knowing whether a report was generated traditionally or with model support.

Fourth, the study will include an error and safety analysis. Errors may include omitted findings, added findings not present in the source data, incorrect tooth numbering, inconsistent terminology, misleading wording, or statements that could affect clinical interpretation. The purpose of this analysis is to identify types of errors that may occur when large language models are used for this task and to assess their potential clinical relevance.

Finally, the study will assess the potential implementation usefulness of the report-generation workflow. This may include evaluation of usability, perceived time savings, acceptability to users, clarity of generated text, and the need for human review before clinical use.

All generated reports will require expert evaluation in the study setting. The system is intended to support documentation research and workflow assessment, not to replace professional judgment. The study will provide evidence on whether language-model-assisted transformation of structured dental radiology data into narrative reports is feasible, accurate, safe, and potentially useful for future clinical documentation workflows.

Inclusion Criteria:

• Dental radiology records based on dental X-ray examination performed on the basis of a written referral from a dentist or physician
• Dental X-ray examinations performed for screening, diagnostic, or treatment-planning purposes
• Records from patients with permanent dentition after completion of exfoliation

Exclusion Criteria:

• Records from patients with mixed dentition before completion of exfoliation
• Records with incomplete, ambiguous, or internally inconsistent structured dental radiology data preventing reliable report generation
• Records with missing information required for evaluation of the generated report
• Duplicate records from the same radiographic examination
• Records in which anonymization or pseudonymization cannot be ensured

The study population will consist of dental radiology records from patients admitted to the radiology department in Kielce, a city in southern Poland with approximately 200,000 inhabitants. Eligible records will include dental X-ray examinations performed on the basis of a written referral from a dentist or physician, including examinations performed for screening, diagnostic, or treatment-planning purposes. The study will include records from patients with permanent dentition after completion of exfoliation, provided that structured dental radiology data are available for transformation into narrative radiology reports.

The investigators plan to share a de-identified structured dataset containing symbolic dental pathology notation derived from panoramic dental radiographs, for example tooth-level coded entries such as "16DR", "15M", or "14C". The shared dataset will not include radiographic images, names, dates of birth, personal identifiers, or other directly identifying information. Data sharing will be performed in accordance with the approval and conditions specified by the Bioethics Committee. The dataset will be shared to support transparency, reproducibility, and independent verification of the large language model-assisted report generation task.

Beginning at the time of publication of the main study results and available for at least 5 years.

The de-identified structured dental pathology notation dataset will be made available as supplementary material accompanying the publication of the main study results or through a scientific data repository. The shared data will not include radiographic images, direct identifiers, dates of birth, names, or other directly identifying information.