1. Dave Kelton Schick Technologies, Inc.
Schick CDR PanX
Dave Kelton
Schick Technologies, Inc.
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2. PanX - Front View
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3. PanX - Side View
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4. MAIN PARTS of the PanX 3 1. Column 2 2. Carriage
3. C-Arm or Rotating Unit
4. Tubehead
5. Receptor
6. Bite Stick / Chin Rest
7. Exposure Switch 2 5 4 7 6 1
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5. Parts - Side View 1 1. Exposure Light 2. Control Panel
3. Mid-Sagittal alignment light
4. Frankfort Plane alignment light
5. Focal Trough light
6. Electro-Mechanical Brake button
7. On – Off switch
8. Patient handles 3 2 4 6 7 5 8
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7. The 3 Most Important Requirements to Achieve Great Pan Images
1. Patient Positioning!
2. Patient Positioning!
3. Patient Positioning!
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8. [see example – next slide]
NEW TERMS (?)
Zygomatic Arch – the slightly protrusive bony ridge that runs along a line from the middle of the ear to the anterior to form the lower border of the Orbit.
Tragus – the small flap anterior in the external ear; better shown than described.
Frankfort Plane – the line from the upper border of the Tragus of the ear, along the Zygomatic Arch to the lower border of the Orbit. It represents a horizontal line, parallel to the floor. Used in positioning the patient.
Mid-Sagittal Plane/Line – a vertical line, bisecting the head, extending down the nasal spine and generally between the proximal surfaces of the central incisors. Used in positioning the patient. The head can often not be symmetric, so this requires some attention on the operator’s part.
Focal Trough or Image Layer – an elliptical area of focus built in by each panoramic unit manufacturer to maintain constant focus during the exposure; it is measured in millimeters and may change in width during the excursion/rotation (i.e. – narrower in the anterior and wider laterally); set for each patient during positioning.
[see example – next slide]
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9. EXPLANATION OF FOCAL TROUGH
RECEPTOR
TARGET
FOCAL
TROUGH
TARGET
Origination of X-ray
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14. Patient Positioning (step-by-step)
1. Have the patient remove all jewelry, metal hairclips, and eyeglasses (tongue studs, too!).
2. Evaluate the patient’s size and bone structure to determine proper kV and mA settings – set control panel accordingly.
3. Position the c-arm for patient entry.
4. Adjust the chin rest or lip support to slightly above the patient’s chin.
5. Walk the patient straight into the unit.
6. Have the patient hold the handles.
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15. Patient Positioning (step-by-step)
7. Adjust the patient’s toes to within approximately 6” of the column.
8. Have the patient center their upper and lower centrals in the grooves on the bite stick.
9. Lower the carriage to where the Zygomatic Arch “appears” to be horizontal. Patient should feel like their neck is being stretched.
10. Activate the positioning lights.
11. Check Frankfort Plane to ensure light is at the upper border of the Tragus, follows the Zygomatic Arch, and ends at the lower border of the Orbit.
12. Have the patient open their lips and set the focal trough light proximally between the lateral and canine.
13. Ensure that the Mid-Sagittal light runs as central to the head as possible.
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16. Patient Positioning (step-by-step)
14. Press the exposure switch one time – this will rotate the c-arm to the READY position.
15. Re-activate the positioning lights to ensure correct position still maintained.
16. Have the patient relax their lips around the bite stick.
17. Click on the highlighted pan box on the computer monitor
18. Tell the patient to swallow, hold their tongue in the roof of their mouth, and remain still for the entire exposure time.
19. Press and hold the exposure button for the duration of the rotation, then release the button.
20. After the c-arm has stopped rotation, press the exposure button one time, the c-arm will go to the patient exit position – tell patient to relax and step out of the unit.
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18. Correct Positioning
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20. Chin Too Far Up
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22. Chin Too Far Down
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23. Tongue Not In Roof of Mouth
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24. Focal Trough Too Far Posterior
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25. Focal Trough Too Far Anterior
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26. Patient Not Centered
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29. Quickie Quiz

30. Chin Too Far Up

31. Chin Too Far Down
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32. Tongue Not In Roof of Mouth
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33. Focal Trough Too Far Posterior
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34. Focal Trough Too Far Anterior
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35. Patient Not Centered
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36. Technique Factors CDR PanX Technique Factors kV mA Male 66, 68, 70 8
Female , 66,
Child ,
(+/- 12 yrs.)
Bold type represents an average skeletal structure – increase or decrease kV depending on skeletal size of patient.
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37. Discussion/ Q & A
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