Panoramic positioning errors Flashcards
What protective measure cannot be used in panoramic radiographs?
thyroid collar
Before taking a pano, have patients remove:
- dental appliances
- earrings
- necklaces
- hair pins
- glasses
What error is seen in this pano?
glasses left on
What error is seen in this pano?
earrings left on
What error is seen in this pano?
necklace left on
What error is seen in this pano?
hair pins
What error is seen in this pano?
denture left in
If the teeth and jaws are sharply depicted in a pano, this tells you:
proper position achieved- teeth and jaws are in focal trough
If there is a slight curvature of the occlusal plane in a pano, this tells you:
proper position achieved- vertical head position is correct
If their is equal magnification on the left and right side of a pano, this tells you:
proper position achieved- head not turned left or right
If their is no air space obstructing the view of the maxillary roots in a pano, this tells you:
proper position achieved- patients tongue is flat on roof of mouth
If their is no ghost image of the cervical spine in the midline of a pano, this tells you:
proper position achieved- patient is standing up fairly straight with neck straight
Some patients can’t stand up straight so you will know ahead of time that their will be:
ghost image of cervical spine
What do we notice about the cervical spine and ramus in the following radiograph?
They are NOT overlapping = good - patient was standing up straight
In a pano, if the anterior teeth are narrow & blurred, what is the positioning error?
Patient too far forward
In a pano, if the cervical spine is superimposed on the ramus, causing a double real image of the cervical spine what is the positioning error?
Patient too far forward
What errors can be seen in the following radiograph? What is the cause of these errors?
- anterior teeth are narrowed & blurred
- cervical spine is superimposed on ramus (double real image of cervical spine
Cause: too far forward
What errors can be seen in the following radiograph? What is the cause of these errors?
- anterior teeth are narrowed & blurred
cause: too far forward
(notice posterior teeth appear normal)
In a pano, if the anterior teeth are widened and blurred what is the positioning error?
too far back
In a pano, if the inferior turbinates and meati spread across maxillary sinuses, what is the positioning error?
too far back
In a pano, if condyles are close too or cut off the side of the image, what is the positioning error?
Too far back
What errors are caused by the patient being positioned too far forward? (2)
- anterior teeth narrowed and blurred
- cervical spine superimposed on ramus (double real image of cervical spine)
What errors are caused by the patient being positioned too far back? (3)
- anterior teeth widened and blurred
- inferior tubercles and meati spread across maxillary sinuses
- condyles close to or cut off side of image
What are the errors in this radiographs? What is the cause of these errors?
- anterior teeth widened & blurred
- inferior tubercles and meati spread across maxillary sinuses
- condyles are close to or cut off side image
Cause: Pt too far back
What are the errors in this radiographs? What is the cause of these errors?
- anterior teeth widened & blurred
- inferior tubercles and meati spread across maxillary sinuses
- condyles are close to or cut off side image
Cause: Pt too far back
What is the main error in this radiograph? What is the cause?
inferior tubercles and meati spread across maxillary sinuses
What positioning error causes excessive curvature of the occlusal plane?
Chin down
What positioning error causes roots of mandibular anterior teeth to be blurred:
Chin down
What positioning error causes the rami/condyles tipped inward?
Chin down
What positing error causes condyles to be close to or cut off the top of the image?
Chin down
What positioning error causes the hyoid bone to be superimpose on the mandible:
Chin down
What errors are caused by the chin being too far down? (5)
- excessive curvature of the occlusal plane
- roots of mandibular anterior teeth are blurred
- rami/condyles are tipped inward
- condyles are close to or cut off top of image
- hyoid bone superimposed on mandible
What errors can be seen in the following radiograph, what is the cause?
- excessive curvature of the occlusal plane
- roots of mandibular anterior teeth are blurred
- rami/condyles are tipped inward
- condyles are close to or cut off top of image
- hyoid bone superimposed on mandible
Cause: chin down
What errors can be seen in the following radiograph, what is the cause?
- excessive curvature of the occlusal plane
- rami/condyles are tipped inward
Cause: chin down
What positioning error causes a flat occlusal plane or reverse curvature?
chin up
What positioning error causes the roots of maxillary anterior teeth to be blurred?
chin up
What positioning error causes the rami/condyles to tip laterally?
chin up
What positioning error causes the hard palate to be superimposed on maxillary apices?
chin up
What positioning error causes the condyles to be close to or cut off the side of the image?
chin up
What happens to the hard palate in a pano if the chin is too upward?
The hard palate gets projected down and overlaps apices of maxillary teeth
What is the maintaining reason we have to retake panoramic images?
Hard palate superimposed on maxillary apices (chin up)
What are some errors that can be seen on this radiograph? What is the cause?
- flat occlusal plane or reverse curvature
- roots of maxillary anterior teeth are blurred
- rami/condyles tipped laterally
- condyles close to or cut off side of image
- hard palate superimposed on maxillary apices
Cause: chin up
What are some errors that can be seen on this radiograph? What is the cause?
- Reverse curvature of occlusal plane
- hard palate projecting downwards overlapping apices of maxillary teeth
Cause: chin up
What positing error results in unequal magnification of left and right side (teeth, ramus)?
head turn
What positioning error results increased blurring and overlapping of contacts on one side?
Head turned
What errors in a pano are caused by chin up?
- flat occlusal plane or reverse curvature
- roots of maxillary anterior teeth are blurred
- rami/condyles tipped laterally
- condyles close to or cut off side of image
- hard palate superimposed on maxillary apices
What errors in a pano are caused by head turned?
- unequal magnification of left and right side (teeth, ramus)
- increased blurring & overlapping of contacts on one side
What errors can be seen in the following pano? What is the cause?
- unequal magnification of left and right side (teeth, ramus)
- increased blurring & overlapping of contacts on one side
Cause: head turned
in the following image, list what each color represents (blue, black, red):
blue: area of focal trough
red: jaw position in focal trough
black: head turned to right with incisors still on anatomic midline
When the head is turned to the right the _______ dentition moves closer to the sensor so the teeth will project _____ on the radiographic image
posterior left dentition; narrower
When the head is turned to the right the _______ dentition moves farther from the sensor so the teeth will project _____ on the radiographic image
posterior right dentition; wider
Based on the left posterior dentition appearing wider on this pano, what error is made?
Head is turned to the left so the posterior left dentition moves further away from the sensor and the teeth project wider on the radiographic image
If bite causes teeth to be closer to the sensor, how will the teeth on the side closer to the sensor appear?
closer=narrower
Anatomic midline shifted to the left of center of focal trough is referred to as:
lateral translation
Due to this left side shift, posterior teeth on the left side will be closer to the sensor and project _____ on the radiographic image
narrower
Due to this left side shift the posterior teeth on the right side will be farther away from the sensor and project ____ on the radiographic image
wider
If the patient is slumped, what results in the pano?
ghost image of cervical spine
What error can be seen on the following image? What is the cause?
Ghost image of cervical spine
Cause: slumped patient
What error can be seen on the following image? What is the cause?
Ghost image of cervical spine
Cause: slumped patient
What error is seen in the following image? What is the cause?
Palatoglossal air space
Cause: tongue not on roof of mouth
What error is seen in the following image? What is the cause?
Palatoglossal air space
Cause: tongue not on roof of mouth
What error is seen in the following radiograph?
Lead apron artifact
What error is seen in the following radiograph?
Ghost image of cervical spine (patient hunching)
Lead apron artifact
This pano represents:
partial panoramic image
What error likely caused the following pano?
Patient movement
