Procedural Steps

Unit Preparation

• Ensure machine is on and ready for patient imaging.
• Use standard infection control procedures to prepare the unit.^5,20
• Place clean barriers over components that will contact the patient.
• Insert sterile panoramic bite block.
• Create patient file to acquire the image.
• Set the exposure factors based on patient size and stature.

Patient Preparation

• Explain the procedure to the patient prior to unit entry and positioning.
• Instruct patient to remove head and neck metallic objects and safely store them.
• Instruct patient to take out any intraoral protheses and safely store them.
• Have patient stand straight with erect spine and relaxed shoulders.

Patient Positioning

• Adjust machine height so that carriage clears the patient's shoulders.
• Instruct patient to step into the machine grabbing low on the handholds.
• Guide the patient's head between the open temple bars while keeping the spine erect.
• Raise the bite piece so that the patient can bite edge-to-edge with the front teeth.
• If patient is edentulous, use cotton rolls to replace the anterior teeth.
• Lower the bite piece until the patient's chin is resting on the chin rest.
• Close the temple bars and turn on the alignment lights.
• Facing the patient, align the midsagittal head plane perpendicular to the floor.
• From the side, align the Frankfort horizontal plane parallel to the floor.
• From the corner, align the anteroposterior plane with the ala of nose or machine specific landmark.

Pre-exposure Instructions

• Instruct the patient to swallow and press the entire tongue against the roof of the mouth.
• Instruct the patient to close the lips around the bite piece.
• Instruct the patient to close their eyes to avoid tracking the machine movement.
• Let the patient know that the machine may brush their shoulders during the procedure.
• Instruct the patient to hold completely still until the machine stops.

Dismissal Positioning

• Instruct the patient to release the bite piece.
• Instruct the patient to hold the hand grips until they step back and are stable.
• Check the image for diagnostic quality before saving. Retake only if necessary.
• Return oral prostheses and head/neck metallic objects to the patient.
• Guide patient back to the operatory.
• Return to unit and complete follow-up infection control procedures.^5,20