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Panoramic Radiographs: Technique & Anatomy Review

Course Number: 533

Use of Panoramic Imaging for Patient Education

With the abundance of information readily available on the internet, patients are becoming more informed about health care. The dental patient may ask why radiographic images are necessary instead of just agreeing to the treatment. Because of this, the dental professional must be able to accurately interpret the panoramic image and educate the patient. It is important to have the patient actively involved with their treatment. Incorporating this information into the patient’s appointment will help improve their understanding of their oral condition and increase the perceived value of the appointment. Patients desire to be informed about their health and treatment options. Taking time to explain the images and educate the patient will help meet this expectation.

According to Rondon, panoramic imaging is helpful for the following situations (Table 6):

Table 6. Uses for Panoramic Images.8

  • General surveys of oral health
  • Best radiographic supplements for surgical procedures
  • Evaluations for orthodontic treatment
  • Pediatric growth and development
  • Chronological dental eruption
  • Evaluating cysts or neoplastic lesions
  • Measurements for implantology
  • Historical documentation
  • Evaluation of TMJ

The following case of Patient A provides examples of using panoramic images to evaluate pediatric development and orthodontic treatment. Figure 9 is a pano of Patient A, who was 9 years old and had mixed dentition. The clinician explained the process of tooth development to the parent and the possibility of orthodontic treatment in the future, due to the rotation of teeth #22 & 27. Figure 10 is Patient A when they were 15 years old. The clinician explained that the wisdom teeth may need to be extracted and was able to involve the parent and patient by explaining what was seen on the panoramic image. This pano provided a great visual to help them understand their current condition and how it compared to the imaging from 6 years earlier. In Figure 10, teeth #22 & 27 were still rotated, but not causing problems currently.

Image of interpretation.

Figure 9. Patient A: Part 1

Panoramic image of Patient A (9 y/o) with rotated mandibular canines and mixed dentition.

Image of anatomy.

Figure 10. Patient A: Part 2

Panoramic image of Patient A (15 y/o).

In the next case, Patient B presented to the dental office with a complaint about their front tooth. After taking the panoramic image (Figure 11), it was noted that tooth #9 had resorption on the root. The dentist then requested a periapical radiograph to evaluate the condition more closely (Figure 12). Upon review of the periapical image, it was confirmed that internal resorption was occurring in tooth #9 and the dentist was able to treat the condition accordingly.

Image of internal resorption.

Figure 11. Patient B: Part 1

Panoramic image of Patient B taken after the patient reported discomfort in their front tooth.

Image source: Dr. Iwata

Image of internal resorption.

Figure 12. Patient B: Part 2

Panoramic image of Patient A (15 y/o).

Image source: Dr. Iwata