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Concepts of

Panoramic
Radiography
Introduction
DHY 202 Clinical Radiology I
Dental Hygiene Department
William Rainey Harper College

Introduction to Panoramic
Radiography
Commonplace in dental practice
Considered essential in radiographic
diagnosis
30% of dental units sold are
panoramic

Introduction to Panoramic
Radiography
Panorama means unobstructed
view of a region in any direction
Panoramic radiograph show greater
coverage than periapical and
bitewing radiographs

Introduction to Panoramic
Radiography

New technique
Introduced in 1959
Employs scanography (slit beam) &
curved surface rotational
tomography

Client Dose from Panoramic


Radiography
10 times less radiation than a
complete intraoral survey using long,
round PID & E+ film
4 time less radiation than a bitewing
survey using long, round PID and E+
film

Indications for Panoramic

Pathology-cysts, tumors
Trauma-fractures
Growth & development
Client management
Edentulous
Localization: anatomy, objects,
implant placement
Carotid artery condition

Advantages of Panoramic
Radiography

Field size
Quality control
Simplicity
Time & rapidity of the procedure
Client cooperation
Dose
Minimal infection control
Gross anatomy & pathology visible

Disadvantages of
Panoramic Radiography

Image quality
Focal trough limitations
Equipment costs
Overuse

Disadvantages of
Panoramic Radiography
Image quality
Magnification
Distortion
Poor definition compared to intraoral
Overlap
Superimposition & ghost images

Disadvantages of
Panoramic Radiography
Poor image quality due to
Tomographic process
Increased object-film distance
Use of intensifying screens
Faster film with larger crystals

Disadvantages of
Panoramic Radiography
Focal Trough (Image Layer)
Areas outside are not visible
Size & shape limits imagery to those
structures which fit into the image
layer
Size & shape not adjustable so not all
clients arches image equally well

Disadvantages of
Panoramic Radiography
Distortion
Vertical & horizontal distortion with
variations causes uneven magnification

Disadvantages of
Panoramic Radiography
Superimposition & Ghost Images
All objects in the field of the beam, even
those outside of the image layer are
projected onto the film but most are not
seen.
Objects with the greatest density are
projected in two places on the film
Intended (useable image)
Ghost image (reversed, higher, blurred)
Frommer 2001

Disadvantages of
Panoramic Radiography
Superimposition & Other Imaging
Quirks
Ghost images may hide pathosis
Soft tissue shadows may mimic
pathosis