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INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com
PANORAMIC RADIOGRAPHY
www.indiandentalacademy.com
Panorama – an unobstructed region in any
direction
www.indiandentalacademy.com
history
 described by Numata & Paatero
 Hudson & Blackman
 first orthopantomography in 1961
www.indiandentalacademy.com
Principle
 Reciprocal movement
of x ray source &
image receptor
 Patient remains
stationary
 Plane of acceptable
detail
www.indiandentalacademy.com
Focal trough / corridor
www.indiandentalacademy.com
Temperomandibular Joint
Panoramic radiograph
TMJ Tomogramwww.indiandentalacademy.com
Other radiographic techniques
TMJ
Linear
tomography
Computed
tomography
TMJTMJ
Transpharyngeal
Transcranial
Lateral
oblique
OPG
www.indiandentalacademy.com
Reverse panoramic radiograph
www.indiandentalacademy.com
procedure
Rotograph 230 - 1992
Chin rest removed
www.indiandentalacademy.com
procedure…..
Explain the procedure
Remove the eyeglasses, earrings
Sit / stand in reverse position
Mid saggital plane perpendicular
Frankfort line parallel
Mouth open / closed
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
To view the lateral aspect of the condyle
Patient positioning is critical
Speed is reduced
Image layer is slightly closer to the centre
of rotation
Restricted mouth opening
www.indiandentalacademy.com
errors
• Patient placed more anteriorly
www.indiandentalacademy.com
errors…..
• tilting of the head
www.indiandentalacademy.com
Advantages
 Clear and less distorted view
 Simplicity
 Easy quality control
 Trismus snd uncooperative patient
Limitations
 Patient positioning
 Exposure to eye
www.indiandentalacademy.com
Comparison of dosage in standard and reverse
positions using a Rando phantom
Sites Reverse cGy
Williams
Standard cGy
Williams
Left eye 0.003 0.002
Right eye 0.003 0.002
Left external TMJ 0.010 0.007
Right External TMJ 0.007 0.006
Left Mastoid 0.006 0.006
Right mastoid 0.004 0.005
Back neck 0.002 0.008
Centre tongue 0.035 0,013
Williams F J, Hudson F R, Markus A F, Rotational panoramic radiography –
a comparison of radiation doses in the standard and reverse position
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com

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