# Multimodal AI and Large Language Models for Orthopantomography Radiology Report Generation and Q&A
## 7 Conclusions  
In conclusion, this study highlights the potential of multimodal artificial intelligence and large language models to improve access to high-quality dental healthcare in developing countries. We conceptualized and developed an automated radiology report generation system and a dental question-answering (Q&A) platform in the Sinhala language, benefiting both dental professionals and patients. The LLM language adaption procedure described in this study for Sinhala can be readily extended to other languages. The prototype system proposed utilizes a Blip-2 model for token generation, followed by a continued pre-trained and instructed fine-tuned LLama 3 8B model for report generation and content generation for the Sinhala Q&A session. Our approach highlights a cost-effective and efficient training methodology for the domain adaptation of LLMs. Data augmentation techniques, particularly grid distortion and elastic transformation, were also employed to address the shortcomings related to the scarcity of dental data. All things considered, these techniques enhanced the model training and raised the diagnostic accuracy. For instance, the overall system architecture resulted in an accuracy of 81.3% for radiology report generation. Moreover, the models can be further improved by using DPO after collecting human feedback over time. By incorporating feedback from medical and dental professionals, the model can be refined to enhance its accuracy, relevance, and usability, ultimately leading to better support for healthcare providers and patients. Furthermore, as a standalone system, our approach also ensures the protection of patients' privacy, which is a critical concern in healthcare, as the proposed model is able to deploy independently at standalone devices. Finally, the authors hope to improve this work's generalizability in subsequent research. This will ultimately improve patient care and clinical outcomes by strengthening the system's resilience and applicability across a larger range of medical settings and diseases. Conceptualization: C.D. and K.D. ; methodology design: C.D., K.D. and M.B.D. ; data curation: C.G., R.J., C.D. and K.D. ; Investigation, C.D., K.D. and M.B.D. ; Resources, C.D., K.D., C.G. and R.J.; Visualization, C.D. and K.D. ; validation: C.D., K.D., M.B.D., C.G. and R.J.; writing--original draft preparation: C.D., K.D. and M.B.D. ; writing--review and editing: C.D., K.D., M.B.D. and R.J.; supervision and project administration: M.B.D., Funding Acquisition, M.B.D. and R.J. All authors have read and agreed to the published version of the manuscript. This research received no external funding. Ethical clearance was obtained under the guidelines and regulations set by the respective hospital ethics committees and international ethical standards. Informed Consent Statement: Informed consent was obtained from all subjects involved in the study. The complete codebase used for this research is available at [[https://github.com/ChirathD/Radiology-Report-Generation](https://github.com/ChirathD/Radiology-Report-Generation)]([https://github.com/ChirathD/Radiology-Report-Generation](https://github.com/ChirathD/Radiology-Report-Generation)) (accessed on 13 March 2025). The authors declare no conflicts of interest. **Patient Information:** Patient Name:  
Date of Birth:  
Referring Physician:  
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**Clinical History:** Not Present  
**Imaging Study:** Dental Panoramic Tomography (Pantomogram)  
**Findings:** The dental panoramic tomography image reveals the following findings:  
1. **Grossly Carious Teeth:** Multiple teeth exhibit extensive carious lesions, indicating severe dental decay. 2. **Caries:** Additional carious lesions are present, affecting various teeth. 3. **Pulp Cacification:** Evidence of pulp calcification is observed, which may indicate chronic pulpitis or aging. 4. **Mild Generalized Bone Loss:** There is a mild level of generalized bone loss in both the maxilla and mandible, potentially indicative of early periodontal disease.