11 Panoramic selection and errors

Question 1

panoramic selection criteria

Answer 1

visualize:
lesion beyond borders of intraoral radiographs
following traumatic injuries
3rd molars,impacted teeth, and mixed dentition
developmental anomalies and repair
evaluation of asymmetry, swelling, and pain
examine alveolar ridge during denture fabrication
maxillary sinus and TMJ

Question 2

common panoramic errors

Answer 2

glasses left on patient
dentures left in mouth
earrings, other piercings, jewelery left on
hearing aid and hairpins left in
certain types of braided hair extensions
lead apron sticking up

Question 3

motion artifact

Answer 3

single vertical disturbance indicates patient swallowed

multiple disturbances seen with tremor disorders

Question 4

cassette backwards

Answer 4

internal cassette objects (screws) seen on image

Question 5

pan positioning error: chin down

Answer 5

V-shaped mandibular profile and hard palate, exaggerated curve of spee, condyles near or off top of film, rami overly vertical

Question 6

pan positioning error: chin up

Answer 6

flat mandibular profile, flat occlusal plane or reverse curve of spee, inverted V-shaped hard palate line, condyles near or off lateral border of film, rami flared laterally

Question 7

pan positioning error: too far forward

Answer 7

anterior teeth appear very narrow, cervical spine overwhelm rami, structures blurred

Question 8

pan positioning error: too far back

Answer 8

anterior teeth appear too wide, cervical spine disappears off lateral edges of film

Question 9

pan positioning error: head twisted

Answer 9

teeth closer to tubehead appear wide, others appear narrow

Question 10

pan positioning error: head tilted

Answer 10

angle of mandible and earlobe will be lower on one side

Question 11

pan positioning error: neck slumped

Answer 11

partially opaque triangle appears over anterior mandible

Question 12

pan technical error: static electricity

Answer 12

thin, branching lines in a fern-like pattern, from pulling screen-film combination out of cassette quickly in low humidity

Question 13

pan technical error: cracked/scratched intensifying screen

Answer 13

think opaque line of uniform width in same location on every film

Question 14

pan technical error: pressure mark

Answer 14

thin, curved radiolucency where film held too tightly

Question 15

pan technical error: double exposure

Answer 15

two sets of images on one film

Question 16

pan technical error: light leak

Answer 16

radiolucent line or zone on all films taken due to rip or tear in cassette edge

Question 17

pan technical error: incomplete exposure

Answer 17

exposure button not pressed during entire exposure leading to white zone

Question 18

pan technical error: darkroom exposure

Answer 18

lights turned on in darkroom before film was loaded fully in processor, overexposed portion of film appears black

Question 19

pan technical error: moisture droplets

Answer 19

radiolucent circles from moisture on hands or darkroom surfaces

Question 20

pan technical error: overexposure

Answer 20

film too radiolucent because of radiation overexposure, lower kVp because exposure time can’t be changed