- Ensure machine is on and ready for patient imaging.
- Use standard infection control procedures to prepare the unit.
- 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.
- Explain the procedure to the patient prior to the 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.
- Place panoramic lead apron high in front and low in back.
- Have patient stand straight with erect spine and relaxed shoulders.
- 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.
- 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 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.
- Instruct the patient to 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 procedure.
- Instruct the patient to hold completely still until the machine stops.
- Instruct the patient to release the bite piece.
- Instruct the patient to hold hand grips until they step back and are stable.
- Check the image for diagnostic quality before saving. Retake only if necessary.
- Remove the patient lead apron and hang properly.
- Return oral prostheses and head/neck metallic objects.
- Guide patient back to the operatory.
- Return to unit and complete follow-up infection control procedures.