Panoramic Anatomy

Types of Panoramic Images

Single Real Image

Double Real Image

Ghost Image
 Single Real Image

Only one image results from a given anatomical

structure. The structure is located between the
rotation center and the film and the x-ray beam
only passes through the structure one time.
Most images seen on a panoramic film are of
this type.
 Double Real Image

Two images of a single object are seen on the

film. Double real images are produced by
structures located in the midline. The x-ray
beam passes through these objects twice as
the tubehead rotates around the patient.
Structures that result in double real images
are the hard and soft palates, the hyoid bone
and the cervical spine.
 Ghost Image
Ghost images are formed by dense objects
located between the tubehead and the rotation
center. These ghost images usually result from
external objects such as earrings, but they may be
produced by dense anatomical structures such as
the mandible.

ghost image of earring

(between lines)
 Panoramic Anatomy
The numbers on the diagram below and on the next
slide (air spaces) correspond to the numbers on the key
(slide 9).
11
16
12
2
5 15 13 17
10
6 7 9
8
14
19
1
24
23 21
18
3
44 4
25 42
41 32
20
22
27
40 26 31
29

33
37
39
35
30 28
43 38 36 34
 Air Spaces
46

45 47 45
 Panoramic Anatomy Key
1. maxillary sinus 25. sigmoid notch
2. pterygomaxillary fissure 26. medial sigmoid depression
3. pterygoid plates 27. styloid process
4. hamulus 28. cervical vertebrae
5. zygomatic arch 29. external oblique ridge
6. articular eminence 30. mandibular canal
7. zygomaticotemporal suture 31. mandibular foramen
8. zygomatic process 32. lingula
9. external auditory meatus 33. mental foramen
10. mastoid process 34. submandibular gland fossa
11. middle cranial fossa 35. internal oblique ridge
12. lateral border of the orbit 36. mental fossa
13. infraorbital ridge 37. mental ridges
14. infraorbital foramen 38. genial tubercles
15. infraorbital canal 39. hyoid bone
16. nasal fossa 40. tongue
17. nasal septum 41. soft palate
18. anterior nasal spine 42. uvula
19. inferior concha 43. posterior pharyngeal wall
20. incisive foramen 44. ear lobe
21. hard palate 45. glossopharyngeal air space
22. maxillary tuberosity 46. nasopharyngeal air space
23. condyle 47. palatoglossal air space
24. coronoid process
9 12
7
19

5 17 13
25 14 6
22
18
39

28
33

9 12 19 7

17 13
14
5 25 6
22
18

39

28 33
 11 2
15
24

26 8 32 23
16 1 31
3
20 4
34 44

30
36
38

11 2
15
24

26 8 32 23
16 1 31
20 3

44
34 30

36
38
 46
21 41
42

47
40 45

43

46 21 41
42

47
40
45

43
R 17 L
2

44 20

28

43
R 11
L
7
1

46 41

47

43
36 45
38
 16

R 23 17 L
2 8

6
21
18 19

39

Red arrows point to ghost image of hard palate

R L

8
46 7

47

33
E

E = epiglottis
R 16 L
10 9

20
3
42 27
30
1

44

36

G = ghost of right mandible

R L

24

26 7

22
27

30

38
R 5
L
10

47

45

ghost of mandible
R 15
L
9 23

7 5
21

44

39
30

Note the relatively inferior location of the mandibular canal (30),

providing plenty of room for the implant.
 Ghost images of earrings

R L
15 2
 Ghost images of earrings

R L