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Panoramic x ray
This document discusses panoramic x-rays and their use in dental practice. It describes how panoramic x-rays provide a wider view than traditional dental x-rays and allow visualization of gross anatomy and pathology. The document outlines advantages like field size and lower radiation dose compared to full mouth x-rays. Disadvantages discussed include potential image quality issues from distortion and superimposition. Proper patient positioning within the focal trough is emphasized as important for diagnostic image quality.
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Panoramic x ray
- 1. Panoramic x-ray Islam Kassem Level 6 ikassem@dr.com
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- 3. High Quality Images,Effortlessly • ikassem@dr.com
- 4. Concepts of PanoramicRadiography Introduction Dr.walaa ikassem@dr.com
- 5. Introduction to Panoramic Radiography • Commonplace in dental practice • Considered essential in radiographic diagnosis • 30% of dental units sold are panoramic ikassem@dr.com
- 6. Introduction to Panoramic Radiography • “Panorama” means unobstructed view of a region in any direction • Panoramic radiograph show greater coverage than periapical and bitewing radiographs ikassem@dr.com
- 7. Introduction to Panoramic Radiography • New technique • Introduced in 1959 • Employs scanography (slit beam) & curved surface rotational tomography ikassem@dr.com
- 8. Client Dose fromPanoramic 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 ikassem@dr.com
- 9. Indications for Panoramic •Pathology-cysts, tumors • Trauma-fractures • Growth & development • Client management • Edentulous • Localization: anatomy, objects, implant placement • Carotid artery condition ikassem@dr.com
- 10. Advantages of Panoramic Radiography • Field size • Quality control • Simplicity • Time & rapidity of the procedure • Client cooperation • Dose • Minimal infection control • Gross anatomy & pathology visible ikassem@dr.com
- 11. Disadvantages of Panoramic Radiography • Image quality • Focal trough limitations • Equipment costs • Overuse ikassem@dr.com
- 12. Disadvantages of Panoramic Radiography • Image quality – Magnification – Distortion – Poor definition compared to intraoral – Overlap – Superimposition & ghost images ikassem@dr.com
- 13. Disadvantages of Panoramic Radiography • Poor image quality due to – Tomographic process – Increased object-film distance – Use of intensifying screens – Faster film with larger crystals ikassem@dr.com
- 14. 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 client’s arches image equally well ikassem@dr.com
- 15. Disadvantages of Panoramic Radiography • Distortion – Vertical & horizontal distortion with variations causes uneven magnification ikassem@dr.com
- 16. 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) ikassem@dr.com
- 17. Disadvantages of Panoramic Radiography • Superimposition & Other Imaging Quirks – Ghost images may hide pathosis – Soft tissue shadows may mimic pathosis ikassem@dr.com
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- 19. Focal Trough • Animaginary, three-dimensional curved area that is horseshoe shaped. • This is a very important concept because many technique errors are caused by improper positioning of the patient’s jaws within the focal trough. • When the jaws are positioned within this area, the radiograph will be clear. • When the jaws are positioned outside of this area, the images on the radiograph will appear blurred or indistinct. ikassem@dr.com
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- 21. Components of thePanoramic Unit • Panoramic x-ray tubehead • Head positioner • Exposure controls ikassem@dr.com
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- 23. The Head Positioner •Each panoramic unit has a head positioner used to align the patient’s teeth as accurately as possible. • Each head positioner consists of a chin rest, notched bite-block, forehead rest, and lateral head supports or guides. • Each panoramic unit is different, and the operator must follow the manufacturer’s instructions on how to position the patient in the focal trough. ikassem@dr.com
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- 27. Positioning of theTeeth • Posterior to focal trough • If the patient’s anterior teeth are not positioned in the groove on the bite-block and are either too far back on the bite-block or posterior to the focal trough, the anterior teeth appear “fat” and out of focus on the radiograph. • Anterior to focal trough • If the patient’s anterior teeth are not positioned in the groove on the bite-block and are either too far forward or anterior to the focal trough, the teeth will appear “skinny” and out of focus. ikassem@dr.com
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- 32. Positioning of theSpine If the patient’s spine is not straight, the cervical spine will appear as a radiopaque artifact in the center of the film and obscure diagnostic information. ikassem@dr.com
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- 43. Common Errors • Patientpreparation errors • Ghost images: A ghost image looks like the real object except that it appears on the opposite side of the film. • Lead apron artifact: If the lead apron is placed too high, or if a lead apron with a thyroid collar is used, a cone-shaped radiopaque artifact results. • Patient seating errors • Chin too high • Chin too low ikassem@dr.com
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- 46. Thank you ikassem@dr.com