Identifying Panoramic Errors

A number of authors indicate that the quality of panoramic radiographs taken either in an institutional setting,13 in general dental practice or submitted to third party insurance providers14 is low. While the majority of radiographs are acceptable, the largest study indicates that up to 1/3rd are diagnostically unacceptable. (Table 1) provides the top 5 technical and processing faults observed in all radiographs and provides the top 5 reasons for diagnostically unacceptable panoramic radiographs.12

Table 1. Top 5 Panoramic Errors by Category.
Technical Errors%
1.Tongue dropped from palate during exposure71.6
2.Anteroposterior position error58.8
3.No side identification35.4
4.Vertical head positioning error31.3
5.Horizontal head positioning error28.0
Processing Errors%
1.Screen artifacts70.8
2.Automatic processor roller marks41.5
3.Localized film fog39.7
4.Contrast too low39.4
5.Density too low36.3
Errors resulting in Unacceptable Radiographs%
1.Anteroposterior position error54.1
2.Density too low40.2
3.Contrast too low37.9
4.Horizontal head positioning error24.0
5.Vertical head positioning error21.9