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 exposure 71.6
2. Anteroposterior position error 58.8
3. No side identification 35.4
4. Vertical head positioning error 31.3
5. Horizontal head positioning error 28.0
.
Processing Errors %
1. Screen artifacts 70.8
2. Automatic processor roller marks 41.5
3. Localized film fog 39.7
4. Contrast too low 39.4
5. Density too low 36.3
.
Errors resulting in Unacceptable Radiographs %
1. Anteroposterior position error 54.1
2. Density too low 40.2
3. Contrast too low 37.9
4. Horizontal head positioning error 24.0
5. Vertical head positioning error 21.9