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Radiography
Introduction
Introduction
Introduction
New technique
Introduced in 1959
Employs scanography (slit beam) & curved surface rotational
tomography
Indications
Pathology-cysts, tumors
Trauma-fractures
Growth & development
Client management
Edentulous
Localization: anatomy, objects, implant placement
Carotid artery condition
Disadvantages of Panoramic
Radiography
Image quality
Focal trough limitations
Equipment costs
Overuse
Disadvantages of Panoramic
Radiography
Image quality
Magnification
Distortion
Poor definition compared to intraoral
Overlap
Superimposition & ghost images
Disadvantages of Panoramic
Radiography
Disadvantages of Panoramic
Radiography
Disadvantages of Panoramic
Radiography
Distortion
Vertical & horizontal distortion with variations causes uneven
magnification
Disadvantages of Panoramic
Radiography
Disadvantages of Panoramic
Radiography
Panoramic Imaging :
General Principles
Panoramic Imaging :
General Principles
Panoramic Imaging :
General Principles
Client remains
stationary while xray
source & film move in
opposite directions in
a fixed relationship
through one or a
series of rotation
points. Rotation points
can be inside or
outside of the focal
trough
Panoramic Imaging :
General Principles
Focal trough in
pantogram
Width & thickness
governed by many factors
Objects lying within the
focal spot are shown
clearly; objects outside
are blurred
Panoramic Imaging :
General Principles
Curved
surface
A panoramic radiograph or
pantomogram is produced using
curved-surface tomography.
Flat
surface
Panoramic Imaging :
General Principles
Rotational panoramic
radiography is
accomplished by rotating a
narrow beam of radiation
in the horizontal plane
around an invisible pivot
point/axis positioned
intraorally.
Film & tube travel in
opposite directions around
the client
Panoramic Imaging :
General Principles
Panoramic Imaging :
General Principles
Panoramic Imaging:
Projection in the Vertical Plane
Vertical dimension unaffected by horizontal rotation
Vertical angulation same as conventional intraoral
projection
Slight negative angulation; passes beneath occipital
area (-4 to -7 degrees)
Panoramic Imaging:
Projection in the Horizontal Plane
Panoramic Imaging:
Projection in the Horizontal Plane
Uniform magnification
Effective focus of
projection
Rotating beam
projected on
stationary film
Panoramic Imaging:
Projection in the Horizontal Plane
Discrepancy in
horizontal versus vertical
magnification eliminated
by using a moving film
to equalize the
magnification in the
horizontal dimension
with the vertical
Panoramic Imaging:
Panoramic Imaging:
Image Layer/Focal Trough Defined
The image layer is a three dimensional curved zone , or focal
truogh , where the structuer line within this layer are reasonably
well defined on final Panoramic Image.
Object outside image layer are blurred, magnified, reduced in
size and are sometimes distorted to an extent of not being
recognizable.
Shape of image layer varies with brand of machine used
Determines where dental arches must be positioned to achieve
clearest image
Panoramic Imaging:
Width of the Image Layer
Determined by
Longer the distance between the rotation centre and the center of
image layer ,wider will be focal through
Panoramic Imaging:
Position of the Image Layer
This is how the image layer is shaped to center the jaws (anteriors
narrower)
Panoramic Imaging:
Image Layer Analysis
Panoramic Imaging:
Image Layer Analysis
Less definition than than intraoral film
More horizontal than vertical
magnification
All objects, even those outside the focal
trough are projected onto the film, but
most are not seen
Objects with the greatest density are
displayed in two places: intended image
and ghost image
PANORAMIC MACHINES
Number of companies manufacture high quality film
based and digital panoramic machines.
Following are the highly versatile machines :ORTHOPANTOGRAPH 100 (Instrumentarium)
ORTHOPHOS PLUS (Sirona)
ORTHORALIX S (Gendex division, dentsply
international)
PROMAX ( PLANMECA )
OTRHOPANTOGRAPH
100
ORTHOPANTOGRAPH 200
In
addition
to
producing
standard
panoramic images of the jaws they have
the capability of adjusting to various sizes
as well as making frontal and lateral
images of TMJ.
Capable of producing tomographic view
through sinuses and cross sectional views
of maxilla and mandible.
PROMAX (PLANMECA) acquires the news
views by using linear tomography program
designed to use SCARA ( Selectively
Compliant Articulated Robotic Arm )
movements with Promax software and
pivoting cassette movements.
PROMAX
ORTHOPHOS PLUS
ORTHORALIX
Evaluating &
SELECTION CRITERIA
OF the Image
Lateral projection
LATERAL PROJECTION
SMV PROJECTION
SMV PROJECTION
Step1 Evaluate the calvarium and posterior
cranial fossa. Assess the foramen magnum,
atlas dens, and occipital condyles. Identify the
petrous ridge of the right and left temporal
bones, the external auditory canals, and the
mastoid air cells. In this and all subsequent
steps, compare the right and left sides and look
for symmetry.
Step 2 Evaluate the middle cranial fossa. Identify
the foramina ovale and spinosum. Assess the
slivus and sphenoid sinuses.
WATER PROJECTION
WATER PROJECTION
POSTEROANTERIOR PROJECTION
POSTEROANTERIOR PROJECTION
Step 1 Evaluate the calvarium, sutures, and
diploic space starting in the area of the left
external auditory meatus (EAM), over the top of
the calvarium, to the right EAM. Look for
intracranial calcifications. Identify the mastoid
are cells and petrous ridge of the right and left
temporal bones. In this and all subsequent
steps, compare the right and left sides and look
for symmetry.
Step 2 Evaluate the upper and middle face.
Identify the orbits, sinuses (frontal, ethmoid,
and maxillary), and zygomatic processes of eh
maxilla. Assess the nasal cavity, middle and
inferior turbinates, nasal septum, and hard
plate.
Selection Criteria