PANORAMIC RADIOGRAPHY
SUBMITTED BY
HANNA HARIS
REG NO :220022090
FINAL YEAR PART 1
2022 BATCH
CONTENTS
•INTRODUCTION
•ORIGIN OF PANORAMIC RADIOGRAPH
•PRINCIPES OF PANORAMIC IMAGE FORMATION
•FOCAL TROUGH
•REAL DOUBLE AND GHOST IMAGES
•IMAGE DISTORTION
•PANORAMIC MACHINES
•IMAGE RECEPTORS
•PANORAMIC FILM DARKROOM TECHNIQUE
•INTERPRETATION OF PANORAMIC RADIOGRAPHY
•INDICATIONS
•CONTRAINDICATIONS
•ADVANTAGES
•DISADVANTAGES
•CONCLUSION
•REFERENCE
INTRODUCTION
•Panoramic radiography also called as pantomography is a radiographic technique
use to produce a single ,wide curved image layer of the maxilla and mandible
•It provides a comprehensive view of the facial structures including :-
•Maxillary and mandibular arches
•Teeth and supporting structures
•surrounding bones and adjacent anatomic structures
ORIGIN OF PANORAMIC RADIOGRAPHY
•Early experiments involved :-
•intraoral film placement
•Movement of x ray source relative of jaws
•In 1933 [Link] introduced slit beam technique using extraoral x ray source
•Later developed by YRJÖ VELI PAATERO coined the term pantomography ,
established modern panoramic technique
•Transition from :-stationary systems-Rational systems
•Modern advancement:-Digital imaging
PRINCIPES OF PANORAMIC IMAGE FORMATION
The principles of panoramic radiography were first described by yrjö veli paatero and
[Link]
•Panoramic imaging is based on the concept of simultaneous movement of
•x ray source
•image receptor
•The technique uses -A narrow vertical x ray beam ,produced using a slite shaped lead
collimator
• A secondary collimator is present between the object and image receptor
•Reduces scattered radiation
IMAGE FORMATION MECHANISM
•The xray beam passes through the patient and
reaches the receptor
•The receptor moves in synchronization with the xray beam
•objects that move at the same speed and direction
as the receptor appears sharp and well defined
•objectsthat do not move in synchronization appears
blurred
RELATIONSHIP OF OBJECTS TO BEAM
•As the disk (representing structures) rotates objects passing through the beam
are recorded sequentially
•The spatial relationship of shadows represents the relationship of actual objects
CENTER OF ROTATION
•The center of rotation plays an important role in panoramic image formation
•In modern panoramic mechines ,The center of rotation is not fixed
•Moves continuously during exposure
•This movement helps in shaping the facial trough
•Matching the curvature of the dental arches
GHOST IMAGES
Structure located between the x ray source and the center of rotation produce ghost
images
•The ghost images are magnified ,Appears blurred ,Are seen at the opposite side of the
image
•Are positioned higher than the actual object
•only structures within the correct path of xray beam and receptors are clearly
visualized
DIGITAL IMAGING
•Modern panoramic systems use digital receptors such as
CCD (charge coupled device)
The receptor must move in synchronization with the xray beam
•Any mismatch in movement can result in image distortion
FOCAL TROUGH
•The focal trough is a three dimensional curved zone in which structures are clearly
visualized on panoramic radiograph
•it Is also called the image layer because only structures within this layer appears sharp
and well defined
•structure:-
*Inside Focal trough -clear image
*outside focal trough-blurred or distorted
•The shape of focal trough depends on movement of the x ray source ,movement of the
image receptor,collimator shape and beam geometry
•In modern machines-The center of rotation moves continuously
This helps in creating wider and more accurate focal trough
positioning importance
•correct patient positioning ensures teeth lie within the focal trough
•Improper positioning-image distortion or loss of detail
REAL DOUBLE AND GHOST IMAGES
REAL IMAGES
•Formed when structure lie between the center of rotation and image receptor
•characteristic:-
•Appear sharp and clear
•located in the correct anatomical position
Example:- Teeth and jaws within the focal trough
DOUBLE IMAGES
Occurs when structures are intercepted twice by the xray beam during rotation
•common structures producing double images :-Hyoid bone
•cervical spine
•Mandibular angles
*charecteristics :-
•Appears twice on both sides
•Usually symmetrical
•Less sharp than real images
Ghost images
•Formed when structure lie between the x ray source and the center of rotatation
Characteristics:-
•Appears on the opposite side
•positioned higher than the real object
•magnified and blurred
Common causes :-
•jewellery (earings,chains)
• Dense anatomical structures (mandible,spine)
Clinical importance :-
•can mimic pathology
• must be identified to avoid misdiagnosis
IMAGE DISTORTION
•panoramic radiography produces inherent distortion due to technique
•Distortion affects :-size ,shape ,position of structures
•Factors affecting distortion :-
•x ray beam angulation
•source to object distance
•object to receptor distance
•position of object in focal trough
•patient positioning errors
HORIZONTAL DISTORTION
•Depends on position of object relative to focal trough
•if object is too far forward -Appears narrow
•Too far backward -Appears widened
VERTICAL DISTORTION
•Determined by distance between x ray source and object
•usually more uniform than horizontal distortion
•Effects of improper positioning :-
•leads to unequal modification
•overlapping of teeth
•Blurring of structures
•Makes linear measurement unreliable
PANORAMIC MACHINES
•Panoramic machines are used to produce
•Extraoral radiographs of maxilllofacial structures
BASIC COMPONENTENTS
•Xray source
•image receptor
•rotating arm
•collimators
WORKING PRINCIPLE
•Based on rotational movement
•x ray source and receptor rotate around the patient
•produces a curved image layer (focal trough)
TYPES OF PANORAMIC MACHINES
•film based systems Lorem ipsum dolor sit amet, consectetur
•Digital systems:-CCD (charge coupled device)adipiscing elit, sed do eiusmod tempor
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•CMOS sensor(complementary metal oxide semiconductor)
FEATURES OF MODERN MACHINES
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•Adjustable focal trough based on patient sizec(adult/child)
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•programs for:- TMJ imaging incididunt ut labore et dolore
•sinus views
•cross sectional imaging
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•Automatic exposure control adipiscing elit, sed do eiusmod tempor
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•Adjusts radiation based on patient dentistry incididunt ut labore et dolore
ADVANTAGES
•wide coverage of jaws and facial bones
•low radiation dose
•quick and easy procedure
LIMITATIONS
•Lower image detail compared to intraoral radiographs
•Presence of distortion ,ghost images
•Requires accurate patient positioning
IMAGE RECEPTORS
IMAGE RECEPTORS IN PANORAMIC RADIOGRAPHY
•Image receptors are used to capture and record the panoramic image
•In modern panioramic imaging ,digital image receptors are widely used
TYPES OF IMAGE RECEPTORS
1)INDIRECT DIGITAL SYSTEMS
•use photostimulable phosphor(psp) plates
•After exposure :The image is stored as a latent image on the psp plate
•It is later processed using a scanner
•The scanned data is converted into a digital image
2)DIRECT DIGITAL SYSTEMS
•use solid state detectors such as
CCD (charge coupled device)
CMO (complementary metal oxide semiconductor)
•These systems :
•convert xrays directly into electric signals
•Display the image immediately on a computer screen
ANATOMICAL STRUCTURES SEEN IN PANORAMIC RADIOGRAPH
DENTITION
The dentition visible in one image
Evaluate
•Number
•position
•Alignment
•Impacted teeth
•caries and restoration
REFERENCE
•WHITE AND PHAROH’S -ORAL RADIOLOGY
•TEXTBOOK OF ORAL MEDICINE ORAL DIAGNOSIS AND ORAL RADIOLOGY-
RAVIKARAN ONGOLE
PRAVEEN BN
THANK YOU