Practical Panoramic Imaging
Patient Positioning Requirements

The basic head alignment used in panoramic imaging is comparable to the recommended head position for maxillary periapical and bitewing radiographic images. The patient’s head should be adjusted so that the midsagittal plane is perpendicular to the floor and the Frankfort horizontal or occlusal plane is parallel to the floor.

However, with panoramic imaging several additional alignment planes are necessary to achieve a consistent diagnostic result. The patient’s head must be centered in three different planes in order to uniformly record the maxillofacial complex. The head alignment planes include the midsagittal, Frankfort horizontal/occlusal and the anteroposterior. Each will be discussed below.