Abstract
Objectives: A panoramic radiograph (PAN) is the most frequently diagnostic imaging technique carried out in dentistry and oral surgery. The correct performance of image acquisition is crucial to obtain adequate image quality. The aim of the present study is to (i) review the principles of PAN image acquisition and (ii) describe positioning errors and artefacts that may affect PAN image quality. Methods: Articles regarding PAN acquisition principles, patient’s positioning errors, artefacts, and image quality were retrieved from the literature. Results: Head orientation is of the utmost importance in guaranteeing correct image acquisition. Symmetry, occlusal plane inclination, mandibular condyles localization, cervical spine position, aspect of upper teeth root apexes, exposure parameters, and metal and motion artefacts are factors that greatly affect the image quality of a successful PAN. Conclusions: Several factors are the basis for PAN performance; therefore, a systematic approach that takes into account correct patient positioning and preparation is strongly suggested to improve overall examination quality.
Highlights
Panoramic radiography is the most frequently prescribed screening examination in dentistry [1,2]
The aim of the present study is to review the principles of panoramic radiograph (PAN) image acquisition and the most common errors that occur during its execution to provide clinicians a guide for the correct performance of this imaging technique
A correct PAN requires the cautious positioning of a patient and an appropriate technique
Summary
Panoramic radiography (orthopantomography, PAN) is the most frequently prescribed screening examination in dentistry [1,2]. This technique has several advantages, a relatively low cost, a low radiation dose, and the possibility of obtaining a comprehensive overview of dental arches, maxillary and mandibular bones, as well as of relevant anatomic structures to be preserved during surgery, such as inferior alveolar nerves and maxillary sinuses [3–5]. PAN has been found to have a high number of line pairs per millimeter (lp/mm), ranging from 1.6 to 3.0 lp/mm [6,7]. According to the literature, PAN has a better number of line pairs than cone beam computed tomography, which is reported to range between 0.6 and 2.8 lp/mm in experimental settings and decreases down to above 1 lp/mm in clinical settings [8]. The lack of fine details of PAN compared to volumetric imaging
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