The basic head alignment used in panoramic imaging is comparable to the recommended head position for maxillary periapical and bitewing radiographs. The patient’s head should be adjusted so that the midsagittal plane is perpendicular to the floor and the occlusal plane is parallel to the floor.
However, with panoramic imaging several additional alignment planes are necessary to achieve a consistent 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, occlusal and the anteroposterior. Each will be discussed below.