Background <p>Accurate radiographic interpretation is essential for diagnostic decision-making in dentistry. Alongside technical training, individual characteristics such as self-confidence and personality traits may influence students’ diagnostic performance.</p> Methods <p>This cross-sectional study included 83 fifth-year dental students who interpreted 11 panoramic radiographs of histopathologically confirmed lesions. Students provided two differential diagnoses and rated their confidence for each case. Personality traits were assessed using the Turkish Big Five 50 Test. ANOVA was used to compare diagnostic accuracy between personality groups, and Hayes’ PROCESS Model 2 examined whether gender or personality moderated the association between confidence and diagnostic accuracy.</p> Results <p>Self-confidence significantly predicted diagnostic accuracy (B = 0.50, 95% CI: 0.22–0.78, <i>p</i> &lt; 0.001). No significant differences were observed among personality profiles (<i>p</i> = 0.549), and neither gender nor personality traits showed significant moderation effects. Diagnostic accuracy was highest in cases where students reported high confidence.</p> Conclusion <p>Self-confidence showed a strong positive association with diagnostic accuracy, whereas personality traits and gender had no significant influence. Educational strategies that enhance confidence calibration and provide structured feedback may help improve radiographic interpretation skills and promote safer clinical decision-making.</p>