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Chapter 30
• Define the key words.

• List uses of panoramic radiography.
• Compare the advantages and limitations of panoramic versus
intraoral radiographs.
• Explain how the panoramic technique relates to the principles
of tomography.
• Identify the three dimensions of the focal trough.
Essentials of Dental Radiography for Dental Assistants and Hygienists, Ninth Edition Copyright ©2012 by Pearson Education, Inc.
Evelyn M. Thomson • Orlen N. Johnson All rights reserved.
• List the components of a panoramic x-ray machine.
• Explain how to use each of the head positioner guides found on
a panoramic
x-ray machine.
• Identify the planes used to position the dental arches correctly
within the focal trough.
 Explain the use of a cape-style lead/lead equivalent barrier or
the use of an apron without an attached thyroid collar.
 List patient preparation errors and describe how these will
affect the appearance of the panoramic radiograph.
 Match the patient-positioning errors with the characteristic
affect on the appearance of the panoramic radiograph.
• List exposure and image receptor handling errors and describe
how these will affect the appearance of the panoramic
radiograph.
• List and identify the anatomic landmarks of the maxilla and
surrounding tissues as viewed on a panoramic radiograph.
• List and identify the anatomic landmarks of the mandible and
surrounding tissues as viewed on a panoramic radiograph.
• List and identify soft tissue images as viewed on a panoramic
radiograph.
• List and identify three air space images as viewed on a
panoramic radiograph.
• List and identify machine part artifacts as viewed on a
• List and identify ghost image artifacts as viewed on a
• Identify in sequence the basic steps in the panoramic
radiographic procedure.
• Ala
• Ala-tragus line
• Cassette holder
• Focal trough (layer)
• Frankfort plane
• Ghost image
• Glossopharyngeal air space
• Head positioner guides
• Midsagittal plane
• Nasopharyngeal air space
• Negative shadows
• Occult disease
• Palatoglossal air space
• Panoramic
• Panoramic radiography
• Rotational center
• Tomography
• Tragus
• The panoramic radiograph is probably the most common
extraoral projection used in general oral health care practice.
• Panoramic radiography refers to a technique for producing a
broad view image of the entire dentition of the maxilla and
mandible with the surrounding alveolar bone, the sinuses, and
the temporomandibular joints on a single radiograph.
• Examining large areas of the face and jaws
• Locating impacted teeth or retained root tips
• Evaluating trauma, lesions, and diseases of the jaws
• Assessing growth and development
• Rotational x-ray tube head
• Cassette holder (for film or phosphor plate) or digital image
receptor
• Head positioner guides
• Exposure control panel
• Location of three facial landmarks to position patient correctly:
• Midsagittal plane
• Ala-tragus line
• Frankfort plane
• Patient preparation
• Positioning
• Exposure and film handling
• The greatest advantage of the panoramic radiograph is that it
can image a large region of structures and provide an increased
amount of diagnostic information when compared to a full
mouth series of intraoral radiographs.
 The greatest limitation of the panoramic radiograph is the
image magnification and distortion that make interpreting the
image difficult.
 The skilled radiographer should be able to identify normal
radiographic anatomy of the maxilla and the mandible,
including soft tissue images and air spaces that appear on a
• The radiographer should be able to distinguish normal
radiographic anatomy from artifacts such as machine parts and
ghost images that appear on the radiograph.
• General
• Chapter Review
• You have to expose a panoramic radiograph on the following
patients today. Each of these patients presents with a
characteristic that will make positioning the patient for the
procedure a challenge. Carefully review each of the patient
descriptions and answer the following questions:
1. What patient positioning step do you anticipate having a
problem with?
2. What error is most likely to occur?
3. What will the image look like?
4. How can you prevent this error from occurring or minimize
the result on the image?
5. Write out the specific steps you plan to take to produce a
diagnostic quality image.
 Case A
A hyperactive 10-year-old child who seems to be having
difficulty paying attention to your directions.
 Case B
A young adult with multiple facial piercings, including a tongue
ring and several earrings.
• Case C
A young woman with fashionable hair extensions gathered into a
large ponytail.
• Case D
A middle-aged man who wears partial dentures that when
removed reveal missing anterior teeth.
 Case E
An older woman with osteoporosis who exhibits a pronounced
stooped posture as a result of collapsed vertebrae.
• Proceed to Chapter 30, Laboratory Application, to complete
this activity.

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Chapter 30

• Define the key words.

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