Panoramic Panoramic Technique ErrorsTechnique Errors

K. Hock, RDH, MAdEdK. Hock, RDH, MAdEd

DHY 202 Clinical Radiology IDHY 202 Clinical Radiology I

Dental Hygiene DepartmentDental Hygiene Department

William Rainey Harper CollegeWilliam Rainey Harper College

IntroductionIntroduction

• It is important to look at other It is important to look at other anatomical features besides the teeth anatomical features besides the teeth when assessing diagnostic quality of a when assessing diagnostic quality of a panoramic radiographpanoramic radiograph..

Assessing The Assessing The Diagnostic Quality of Diagnostic Quality of

Panoramic Panoramic RadiographsRadiographs

• Divide the Divide the panoramic panoramic radiograph into six radiograph into six zones: three are in zones: three are in the midline and the midline and three are bilateralthree are bilateral

ZoneZone1 1

Zone 2Zone 2

Zone 3Zone 3

Zone 4Zone 4

ZoneZone 55

Zone 6Zone 6

Technique Technique ErrorsErrors

Client Client PositioningPositioning

Client Client PreparationPreparation

ExposureExposure

OperationalOperationalFilmFilm HandlingHandling

Client Positioning Client Positioning ErrorsErrors

Antero-Antero-posteriorposterior

Horizontal/Horizontal/MidsaggitalMidsaggital

Cervical SpineCervical SpineVertical/Vertical/ OcclusalOcclusal

Client Preparation Client Preparation ErrorsErrors

ObjectsObjects UnsharpnessUnsharpnessAir Space Air Space ArtifactsArtifacts

Exposure ErrorsExposure Errors

UnderUnderExposedExposed

Over Over ExposedExposed

Double Double ExposureExposure

Operational ErrorsOperational Errors

IncompleteIncomplete ExposureExposure

CassetteCassette ResistanceResistance

Not StartingNot Startingat Home Baseat Home Base

Film Handling & Film Handling & Processing ErrorsProcessing Errors

StaticStaticElectricityElectricity

Debris/Debris/ScratchedScratchedScreensScreens

FilmFilmCrimpingCrimping

WhiteWhiteLight ExposureLight Exposure

Technique Technique ErrorsErrors

Client Client PositioningPositioning

Client Client PreparationPreparation

ExposureExposure

OperationalOperationalFilmFilm HandlingHandling

Client Positioning Client Positioning ErrorsErrors

Antero-Antero-posteriorposterior

Horizontal/Horizontal/MidsaggitalMidsaggital

Cervical SpineCervical SpineVertical/Vertical/ OcclusalOcclusal

Client Positioning Client Positioning ErrorsErrors

Antero-Antero-posteriorposterior

Client too far forwardClient too far forward Client too far backClient too far back

Client Too Far Client Too Far ForwardForward

Client Too Far Client Too Far ForwardForward

Client Too Far Client Too Far ForwardForward

Client Too Far BackClient Too Far Back

Client Too Far BackClient Too Far Back

Client Too Far BackClient Too Far Back

Client Positioning Client Positioning ErrorsErrors

Antero-Antero-posteriorposterior

Horizontal/Horizontal/MidsaggitalMidsaggital

Cervical SpineCervical SpineVertical/Vertical/ OcclusalOcclusal

Client Positioning Client Positioning ErrorsErrors

Horizontal-Horizontal-MidsaggitalMidsaggital

Client head twisted, Client head twisted, turned or rotatedturned or rotated

Client head tiltedClient head tilted

Client Head is Client Head is Twisted, Turned or Twisted, Turned or

RotatedRotated

Client Head is Client Head is Twisted, Turned or Twisted, Turned or

RotatedRotated

Client Head is Client Head is Twisted, Turned or Twisted, Turned or

RotatedRotated

Client Head is TiltedClient Head is Tilted

Client Head is TiltedClient Head is Tilted

Client Head is TiltedClient Head is Tilted

Client Positioning Client Positioning ErrorsErrors

Antero-Antero-posteriorposterior

Horizontal/Horizontal/MidsaggitalMidsaggital

Cervical SpineCervical SpineVertical/Vertical/ OcclusalOcclusal

Client Positioning Client Positioning ErrorsErrors

Vertical headVertical heador occlusal or occlusal

planeplaneClient head /chin is Client head /chin is tipped or tilted tipped or tilted downward or too downward or too lowlow

Client head /chin is Client head /chin is tipped or tilted tipped or tilted upward or too highupward or too high

Client head /chin is Client head /chin is not on the chin restnot on the chin rest

Client Head is Client Head is Tipped/Tilted Tipped/Tilted

Downward or Too LowDownward or Too Low

Client Head is TiltedClient Head is Tilted

Client Head is Client Head is Tipped/Tilted Tipped/Tilted

Downward or Too LowDownward or Too Low

Client Head is Client Head is Tipped/Tilted Upward Tipped/Tilted Upward

or Too Highor Too High

Client Head is Client Head is Tipped/Tilted Upward Tipped/Tilted Upward

or Too Highor Too High

Client Head is Client Head is Tipped/Tilted Upward Tipped/Tilted Upward

or Too Highor Too High

Client Head/Chin is not Client Head/Chin is not on the Chin Reston the Chin Rest

Client Head/Chin is not Client Head/Chin is not on the Chin Reston the Chin Rest

Client Head/Chin is not Client Head/Chin is not on the Chin Reston the Chin Rest

Client Positioning Client Positioning ErrorsErrors

Antero-Antero-posteriorposterior

Horizontal/Horizontal/MidsaggitalMidsaggital

Cervical SpineCervical SpineVertical/Vertical/ OcclusalOcclusal

Cervical Spine ErrorCervical Spine Error

Cervical Spine ErrorCervical Spine Error

Client Client spinal spinal column column is is slumpedslumped

Cervical Spine ErrorCervical Spine Error

Technique Technique ErrorsErrors

Client Client PositioningPositioning

Client Client PreparationPreparation

ExposureExposure

OperationalOperationalFilmFilm HandlingHandling

Client Preparation Client Preparation ErrorsErrors

UnsharpnessUnsharpnessAir Space Air Space ArtifactsArtifacts

ObjectsObjects

Client Preparation Client Preparation ErrorsErrors

ObjectsObjects

Prostheses, Jewelry Prostheses, Jewelry & Removable Item & Removable Item ArtifactArtifact

Apron/Thyroid Apron/Thyroid Shield ArtifactShield Artifact

Object ArtifactsObject Artifacts

Jewelry chain=black arrowJewelry chain=black arrow

Ghost image=arrowheadGhost image=arrowhead

Object ArtifactsObject Artifacts

ProsthesesProstheses

Lead Apron ArtifactLead Apron Artifact

Client Preparation Client Preparation ErrorsErrors

ObjectsObjects Air Space Air Space ArtifactsArtifacts

UnsharpnessUnsharpness

Client Preparation Client Preparation ErrorsErrors

UnsharpnessUnsharpness

Client MovementClient Movement

UnsharpnessUnsharpness

UnsharpnessUnsharpness

Client Preparation Client Preparation ErrorsErrors

ObjectsObjectsAir Space Air Space ArtifactsArtifactsUnsharpnessUnsharpness

Client Preparation Client Preparation ErrorsErrors

Air Space Air Space ArtifactArtifact

Tongue not on palate and Tongue not on palate and lips openlips open

Air Space ArtifactAir Space Artifact

Tongue Tongue not on not on

palate and palate and lips openlips open

Air Space ArtifactAir Space Artifact

Technique Technique ErrorsErrors

Client Client PositioningPositioning

Client Client PreparationPreparation

ExposureExposure

OperationalOperationalFilmFilm HandlingHandling

Exposure ErrorsExposure Errors

OverOverExposureExposure

DoubleDoubleExposureExposure

UnderUnderExposureExposure

UnderexposureUnderexposure

Exposure ErrorsExposure Errors

UnderUnderExposureExposure

DoubleDoubleExposureExposure

OverOverExposureExposure

OverexposureOverexposure

Exposure ErrorsExposure Errors

OverOverExposureExposure

UnderUnderExposureExposure

DoubleDoubleExposureExposure

Double ExposureDouble Exposure

Technique Technique ErrorsErrors

Client Client PositioningPositioning

Client Client PreparationPreparation

ExposureExposure

OperationalOperationalFilmFilm HandlingHandling

Operational ErrorsOperational Errors

CassetteCassetteResistanceResistance

IncompleteIncompleteExposureExposure

Not StartingNot StartingAt Home BaseAt Home Base

Incomplete Exposure Incomplete Exposure or Not Starting At or Not Starting At

Home BaseHome Base

Operational ErrorsOperational Errors

Incomplete Incomplete ExposureExposure

Not StartingNot StartingAt Home BaseAt Home Base

CassetteCassette ResistanceResistance

Cassette ResistanceCassette Resistance

Cassette ResistanceCassette Resistance

Technique Technique ErrorsErrors

Client Client PositioningPositioning

Client Client PreparationPreparation

ExposureExposure

OperationalOperationalFilmFilm HandlingHandling

Film Handling & Film Handling & Processing ErrorsProcessing Errors

StaticStaticElectricityElectricity

Debris/Debris/ScratchedScratchedScreensScreens

FilmFilmCrimpingCrimping

WhiteWhiteLight ExposureLight Exposure

Black, Black, tree-like tree-like artifactsartifacts

White White artifactsartifacts

Black Black zonezone

Finger-Finger-nail nail

artifactartifact