Panoramic positioning errors

Question 1

What protective measure cannot be used in panoramic radiographs?

Answer 1

thyroid collar

Question 2

Before taking a pano, have patients remove:

Answer 2

1. dental appliances
2. earrings
3. necklaces
4. hair pins
5. glasses

Question 3

What error is seen in this pano?

Answer 3

glasses left on

Question 4

What error is seen in this pano?

Answer 4

earrings left on

Question 5

What error is seen in this pano?

Answer 5

necklace left on

Question 6

What error is seen in this pano?

Answer 6

hair pins

Question 7

What error is seen in this pano?

Answer 7

denture left in

Question 8

If the teeth and jaws are sharply depicted in a pano, this tells you:

Answer 8

proper position achieved- teeth and jaws are in focal trough

Question 9

If there is a slight curvature of the occlusal plane in a pano, this tells you:

Answer 9

proper position achieved- vertical head position is correct

Question 10

If their is equal magnification on the left and right side of a pano, this tells you:

Answer 10

proper position achieved- head not turned left or right

Question 11

If their is no air space obstructing the view of the maxillary roots in a pano, this tells you:

Answer 11

proper position achieved- patients tongue is flat on roof of mouth

Question 12

If their is no ghost image of the cervical spine in the midline of a pano, this tells you:

Answer 12

proper position achieved- patient is standing up fairly straight with neck straight

Question 13

Some patients can’t stand up straight so you will know ahead of time that their will be:

Answer 13

ghost image of cervical spine

Question 14

What do we notice about the cervical spine and ramus in the following radiograph?

Answer 14

They are NOT overlapping = good - patient was standing up straight

Question 15

In a pano, if the anterior teeth are narrow & blurred, what is the positioning error?

Answer 15

Patient too far forward

Question 16

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?

Answer 16

Patient too far forward

Question 17

What errors can be seen in the following radiograph? What is the cause of these errors?

Answer 17

1. anterior teeth are narrowed & blurred
2. cervical spine is superimposed on ramus (double real image of cervical spine

Cause: too far forward

Question 18

What errors can be seen in the following radiograph? What is the cause of these errors?

Answer 18

1. anterior teeth are narrowed & blurred

cause: too far forward

(notice posterior teeth appear normal)

Question 19

In a pano, if the anterior teeth are widened and blurred what is the positioning error?

Answer 19

too far back

Question 20

In a pano, if the inferior turbinates and meati spread across maxillary sinuses, what is the positioning error?

Answer 20

too far back

Question 21

In a pano, if condyles are close too or cut off the side of the image, what is the positioning error?

Answer 21

Too far back

Question 22

What errors are caused by the patient being positioned too far forward? (2)

Answer 22

1. anterior teeth narrowed and blurred
2. cervical spine superimposed on ramus (double real image of cervical spine)

Question 23

What errors are caused by the patient being positioned too far back? (3)

Answer 23

1. anterior teeth widened and blurred
2. inferior tubercles and meati spread across maxillary sinuses
3. condyles close to or cut off side of image

Question 24

What are the errors in this radiographs? What is the cause of these errors?

Answer 24

1. anterior teeth widened & blurred
2. inferior tubercles and meati spread across maxillary sinuses
3. condyles are close to or cut off side image

Cause: Pt too far back

Question 25

What are the errors in this radiographs? What is the cause of these errors?

Answer 25

1. anterior teeth widened & blurred 2. inferior tubercles and meati spread across maxillary sinuses 3. condyles are close to or cut off side image Cause: Pt too far back

Question 26

What is the main error in this radiograph? What is the cause?

Answer 26

inferior tubercles and meati spread across maxillary sinuses

Question 27

What positioning error causes excessive curvature of the occlusal plane?

Answer 27

Chin down

Question 28

What positioning error causes roots of mandibular anterior teeth to be blurred:

Answer 28

Chin down

Question 29

What positioning error causes the rami/condyles tipped inward?

Answer 29

Chin down

Question 30

What positing error causes condyles to be close to or cut off the top of the image?

Answer 30

Chin down

Question 31

What positioning error causes the hyoid bone to be superimpose on the mandible:

Answer 31

Chin down

Question 32

What errors are caused by the chin being too far down? (5)

Answer 32

1. excessive curvature of the occlusal plane 2. roots of mandibular anterior teeth are blurred 3. rami/condyles are tipped inward 4. condyles are close to or cut off top of image 5. hyoid bone superimposed on mandible

Question 33

What errors can be seen in the following radiograph, what is the cause?

Answer 33

1. excessive curvature of the occlusal plane 2. roots of mandibular anterior teeth are blurred 3. rami/condyles are tipped inward 4. condyles are close to or cut off top of image 5. hyoid bone superimposed on mandible Cause: chin down

Question 34

What errors can be seen in the following radiograph, what is the cause?

Answer 34

1. excessive curvature of the occlusal plane 2. rami/condyles are tipped inward Cause: chin down

Question 35

What positioning error causes a flat occlusal plane or reverse curvature?

Answer 35

chin up

Question 36

What positioning error causes the roots of maxillary anterior teeth to be blurred?

Answer 36

chin up

Question 37

What positioning error causes the rami/condyles to tip laterally?

Answer 37

chin up

Question 38

What positioning error causes the hard palate to be superimposed on maxillary apices?

Answer 38

chin up

Question 38

What positioning error causes the condyles to be close to or cut off the side of the image?

Answer 38

chin up

Question 39

What happens to the hard palate in a pano if the chin is too upward?

Answer 39

The hard palate gets projected down and overlaps apices of maxillary teeth

Question 40

What is the maintaining reason we have to retake panoramic images?

Answer 40

Hard palate superimposed on maxillary apices (chin up)

Question 41

What are some errors that can be seen on this radiograph? What is the cause?

Answer 41

1. flat occlusal plane or reverse curvature 2. roots of maxillary anterior teeth are blurred 3. rami/condyles tipped laterally 4. condyles close to or cut off side of image 5. hard palate superimposed on maxillary apices Cause: chin up

Question 42

What are some errors that can be seen on this radiograph? What is the cause?

Answer 42

1. Reverse curvature of occlusal plane 2. hard palate projecting downwards overlapping apices of maxillary teeth Cause: chin up

Question 43

What positing error results in unequal magnification of left and right side (teeth, ramus)?

Answer 43

head turn

Question 44

What positioning error results increased blurring and overlapping of contacts on one side?

Answer 44

Head turned

Question 45

What errors in a pano are caused by chin up?

Answer 45

1. flat occlusal plane or reverse curvature 2. roots of maxillary anterior teeth are blurred 3. rami/condyles tipped laterally 4. condyles close to or cut off side of image 5. hard palate superimposed on maxillary apices

Question 46

What errors in a pano are caused by head turned?

Answer 46

1. unequal magnification of left and right side (teeth, ramus) 2. increased blurring & overlapping of contacts on one side

Question 47

What errors can be seen in the following pano? What is the cause?

Answer 47

1. unequal magnification of left and right side (teeth, ramus) 2. increased blurring & overlapping of contacts on one side Cause: head turned

Question 48

in the following image, list what each color represents (blue, black, red):

Answer 48

blue: area of focal trough red: jaw position in focal trough black: head turned to right with incisors still on anatomic midline

Question 49

When the head is turned to the right the _______ dentition moves closer to the sensor so the teeth will project _____ on the radiographic image

Answer 49

posterior left dentition; narrower

Question 50

When the head is turned to the right the _______ dentition moves farther from the sensor so the teeth will project _____ on the radiographic image

Answer 50

posterior right dentition; wider

Question 51

Based on the left posterior dentition appearing wider on this pano, what error is made?

Answer 51

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

Question 52

If bite causes teeth to be closer to the sensor, how will the teeth on the side closer to the sensor appear?

Answer 52

closer=narrower

Question 53

Anatomic midline shifted to the left of center of focal trough is referred to as:

Answer 53

lateral translation

Question 54

Due to this left side shift, posterior teeth on the left side will be closer to the sensor and project _____ on the radiographic image

Answer 54

narrower

Question 55

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

Answer 55

wider

Question 56

If the patient is slumped, what results in the pano?

Answer 56

ghost image of cervical spine

Question 57

What error can be seen on the following image? What is the cause?

Answer 57

Ghost image of cervical spine Cause: slumped patient

Question 58

What error can be seen on the following image? What is the cause?

Answer 58

Ghost image of cervical spine Cause: slumped patient

Question 59

What error is seen in the following image? What is the cause?

Answer 59

Palatoglossal air space Cause: tongue not on roof of mouth

Question 60

What error is seen in the following image? What is the cause?

Answer 60

Palatoglossal air space Cause: tongue not on roof of mouth

Question 61

What error is seen in the following radiograph?

Answer 61

Lead apron artifact

Question 62

What error is seen in the following radiograph?

Answer 62

Ghost image of cervical spine (patient hunching) Lead apron artifact

Question 63

This pano represents:

Answer 63

partial panoramic image

Question 64

What error likely caused the following pano?

Answer 64

Patient movement