1. Concepts of Panoramic Radiography Introduction
DHY 202 Clinical Radiology I
Dental Hygiene Department
William Rainey Harper College

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

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

4. Introduction to Panoramic Radiography
New technique
Introduced in 1959
Employs scanography (slit beam) & curved surface rotational tomography

5. 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

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

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

8. Disadvantages of Panoramic Radiography
Image quality
Focal trough limitations
Equipment costs
Overuse

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

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

11. 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

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

13. 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

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