Procedural Steps

Table 2. Steps in Panoramic Imaging Procedure.

Unit Preparation

  • 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.

 

Patient Preparation

  • 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.

 

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.
  • 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.

 

Post-exposure Instructions

  • 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.

 

Dismissal Positioning

  • 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.