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      Common positioning errors in panoramic radiography: A review

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          Abstract

          Professionals performing radiographic examinations are responsible for maintaining optimal image quality for accurate diagnoses. These professionals must competently execute techniques such as film manipulation and processing to minimize patient exposure to radiation. Improper performance by the professional and/or patient may result in a radiographic image of unsatisfactory quality that can also lead to a misdiagnosis and the development of an inadequate treatment plan. Currently, the most commonly performed extraoral examination is panoramic radiography. The invention of panoramic radiography has resulted in improvements in image quality with decreased exposure to radiation and at a low cost. However, this technique requires careful, accurate positioning of the patient's teeth and surrounding maxillofacial bone structure within the focal trough. Therefore, we reviewed the literature for the most common types of positioning errors in panoramic radiography to suggest the correct techniques. We would also discuss how to determine if the most common positioning errors occurred in panoramic radiography, such as in the positioning of the patient's head, tongue, chin, or body.

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          Most cited references41

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          Patient radiation dose and protection from cone-beam computed tomography

          Gang Li (2013)
          After over one decade development, cone beam computed tomography (CBCT) has been widely accepted for clinical application in almost every field of dentistry. Meanwhile, the radiation dose of CBCT to patient has also caused broad concern. According to the literature, the effective radiation doses of CBCTs in nowadays market fall into a considerably wide range that is from 19 µSv to 1073 µSv and closely related to the imaging detector, field of view, and voxel sizes used for scanning. To deeply understand the potential risk from CBCT, this report also reviewed the effective doses from literatures on intra-oral radiograph, panoramic radiograph, lateral and posteroanterior cephalometric radiograph, multi-slice CT, and so on. The protection effect of thyroid collar and leaded glasses were also reviewed.
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            The use of panoramic radiology in dental practice.

            Approximately 1.5 million panoramic radiographs are taken annually in the general dental service in England and Wales. The aim of this review was to assess the clinical role of panoramic radiology in the diagnosis of diseases associated with the teeth and to consider its value in routine screening of patients. This was carried out by critical review of the literature. In addition to common problems with radiographic technique and processing, there are limitations in image quality inherent to panoramic radiology. These factors contribute to a reduced diagnostic accuracy for caries diagnosis, demonstration of periodontal bone support and periapical pathology when compared with intraoral radiography. Routine screening is unproductive for large proportions of dentate and edentulous populations, while in those cases where pathology is detected the diagnostic accuracy can be questioned. Furthermore, the "detection' of asymptomatic anomalies may have no effect on patient management. Attempts to develop and test panoramic radiographic selection criteria are reviewed. New, high-yield selection criteria for panoramic radiography are proposed as a means of reducing unnecessary examinations, limiting radiation doses and reducing financial costs to patients and health service providers. However, research is indicated to develop further and to test such selection criteria.
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              Object position and image magnification in dental panoramic radiography: a theoretical analysis.

              The purpose of our study was to investigate how image magnification and distortion in dental panoramic radiography are influenced by object size and position for a small round object such as a ball bearing used for calibration.
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                Author and article information

                Journal
                Imaging Sci Dent
                Imaging Sci Dent
                ISD
                Imaging Science in Dentistry
                Korean Academy of Oral and Maxillofacial Radiology
                2233-7822
                2233-7830
                March 2014
                19 March 2014
                : 44
                : 1
                : 1-6
                Affiliations
                [1 ]Stomathology and Oral Diagnostic Program, School of Dentistry of São Paulo, University of São Paulo, São Paulo, Brazil.
                [2 ]Biology Dental Buco Graduate Program, School of Dentistry of Piracicaba, University of Campinas, Piracicaba, Brazil.
                [3 ]Psychobiology Graduate Program, School of Philosophy, Science and Literature of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
                Author notes
                Correspondence to: Prof. Glauce Crivelaro do Nascimento. Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, 14040-904 Ribeirão Preto, SP, Brazil. Tel) 55-16-3602-4093, Fax) 55-16-3633-0999, glau_nascimento@ 123456yahoo.com.br
                Article
                10.5624/isd.2014.44.1.1
                3972400
                24701452
                434626cf-30cd-4a06-b738-1007f1ec3f38
                Copyright © 2014 by Korean Academy of Oral and Maxillofacial Radiology

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 09 August 2013
                : 11 September 2013
                : 25 September 2013
                Categories
                Review Article

                Dentistry
                panoramic radiography,patient positioning,quality control,review
                Dentistry
                panoramic radiography, patient positioning, quality control, review

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