DAS 105- panoramic xrays

fuck yuo

what does panoramic xray show

A wide view of the maxilla, mandible, and pts overall oral and facial structure

what is the frankfort plane 

imaginary line that passes from bottom of the eye socket to top of ear canal

what is panoramic xray used to evaluate

dentition and supporting structures

impacted teeth

eruption patterns, growth, and development

disease lesions and conditions of the jaw

trauma

what is a pano not used to evalulate 

caries 

periodontal disease

periapical lesions 

what are the fundamentals of pano

receptor and xray tube moves around pt 

tube head moves in one direction and receptor rotates in opposite direction

what is tomography

allows imaging of one section of body while blurring the other sections 

what is the rotation center

pivotal point where receptor and xray tube head rotate

what is the focal trough

three dimensional curved zone where structures are clearly viewed

what is the image resolution when image is inside the focal trough

well defined

image resolution when image is outside focal trough

blurry

how to make the focal trough narrower

get rotation closer to the teeth

what are resultant images

anatomic structures penetrated by xray twice, location of structures determine what type of image results

what is a real image

when structure lies between receptor and moving rotation center

what is a double image

when structure is located behind the moving rotation center

what is the difference and similarity between a double and real image

double image is mirror but has the same proportions as a real image

what is a ghost image

structure located close to pt but outside the focal source ; appears blurred and magnified on opposite side of true angle

what are artifacts

motion

double images

ghost images

suboptimal positioning 

what equipment is used in a pano

xray tube head

head positioner

exposure control

explain tube head

like intraoral tube head but collimator has opening in shape of narrow vertical slit rather than round circle

beam passes thru collimator as narrow band and exposes receptor thru slit

horizontal angulation fixed at -10 degrees

what makes up the head positioner

chin rest, notched bite block, forehead rest, lateral head support

what does the chin rest and bite block do

stabilizes pt dentition in anterior and posterior direction

what does the lateral head supporters do

stabilizes pt head in vertical and horizontal plane

what is unique about exposure factors in a pano

predetermined by manufacturer but radiography can select pt size and type of image being obtained 

wat are the exposure steps

cover biteblock w barrier

select exposure settings

adjust machine height

explain procedure to pt, place lead apron, instruct them to remove jewelry/interfering objects

position spine and have pt stand straight and close to machine

pt position teeth on bite block

have pt heads midsagittal plane be perpendicular to floor and frankfort plane parallel to floor 

what are common errors

ghost images

open lips 

tongue not placed on hard palate

tipped chin

teeth not on biteblock

pt not centered

pt not standing straight

thyroid collar 

what causes ghost images

glasses, jewelry, retainers, etc

why do open lips cause an error in a pano

makes dark radiolucent shadows in anterior region

why tongue not on hard palate matter

radiolucent shadows will appear around the apices of maxillary teeth

wai tipped chin bad

missing condyles

nasal cavity appears superimposed

maxillary incisors distorted

loss o detail

reverse smile line

wai teeth not on biteblock bad

distorts and overlaps the anterior and premolars 

wai pt not centered bad

one side appears closer and other farther

wai pt not standing straight bad

beam will pass thru cervical spine causing radiopacity on image

what are the normal anatomic landmarks

bony landmarks of maxilla, mandible, and surrounding strucutures

air spaces and soft tissues seen on pano images

what is this, its description and its appearance on images

mastoid process

marked prominence of bone located posterior and inferior to TMJ

large rounded radiopacity located posterior and inferior, not seen on intraoral

what is this, its description and its appearance on images

styloid process

long pointed projection of bone that extends downward for the inferior surface of temporal bone

long radiopaque spine that extends from temporal bone anterior to mastoid process, not seen intraoral 

what is this, its description and its appearance on images

external auditory meatus 

hole in temporal bone located superior and anterior to mastoid process

round radiolucency anterior and superior to mastoid process, not seen intraorally 

what is this, its description and its appearance on images

glenoid fossa

concave depressed area of temporal bone

concave radiopacity superior to mandibular condyle, not seen intraorally 

what is this, its description and its appearance on images

articular eminence

projection of temporal bone located anterior to glenoid fossa

rounded radiopaque projection of bone located anterior to glenoid fossa, not seen intraorally 

what is this, its description and its appearance on images

lateral pterygoid plate

thin, wing shaped extension of sphenoid located distal to maxillary tuberosity region

rounded radiopaque projection, not seen intraorally 

what is this, its description and its appearance on images

pterygomaxillary fissure

narrow space that separates the lateral pterygoid plate and maxilla

rounded radiolucent area. not seen intraorally 

what is this, its description and its appearance on images

maxillary tuberosity 

rounded prominence that extends posterior to third molar

rounded radiopaque bulge distal to third molar, seen on intraoral

what is this, its description and its appearance on images

infraorbital foramen

hole in bone inferior to border or orbit

round radiolucency inferior to orbit, not seen intraoral

what is this, its description and its appearance on images

orbit

cavity that contains eyeball

round radiolucent compartment with radiopaque borders located superior to maxillary sinuses, not seen intraoral

what is this, its description and its appearance on images

incisive canal

passageway thru bone that extends from superior foramina from incisive canal to foramen 

tubelike radiolucent area with radiopaque borders, can be seen intraoral img

what is this, its description and its appearance on images

incisive foramen

hole in bone located at midline of anterior hard palate directly posterior to maxillary central incisors 

round radiolucency located btween roots of maxillary central incisors, can be seen intraoral img

what is this, its description and its appearance on images

anterior nasal spine 

sharp projection of maxilla located at anterior inferior portion of nasal cavity and septum

v shaped radiopaque area located at the intersection of floor nasal cav and septum, may be seen

what is this, its description and its appearance on images

nasal cavity

pear shaped compartment of bone located superior to maxilla

v shaped radiolucent area superior to maxillary incisors, may be seen 

what is this, its description and its appearance on images

nasal septum

vertical bony wall that divides nasal cavity into left and right fossae 

may be seen 

what is this, its description and its appearance on images

hard palate

wall that separates nasal cavity from oral 

horizontal radiopaque band superior to apices of maxillary teeth, may be seen 

what is this, its description and its appearance on images

maxillary sinus

paired cavities within the maxilla superior to maxillary posterior teeth

radiolucent apreas superior to apices of maxillary premolars and molars, may been seen 

what is this, its description and its appearance on images

zygomatic process of maxilla

projection of maxilla that articulates with zygoma

j or u shaped radiopacity located superior to maxillary first molar region, may be seen

what is this, its description and its appearance on images

zygoma

cheekbone

diffuse radiopaque band that extends posteriorly from zygo process of maxilla, may be seen 

what is this, its description and its appearance on images

hamulus

small hooklike projection that extends from medial pterygoid plate 

radiopaque, may be seen 

what are the bony landmarks of the maxilla and surrounding structures

mastoid porcess

styloid process

external auditory meatus

glenoid fossa

articular eminence

lateral pterygoid plate

pterygomaxillary fissure

maxillary tuberosity

infraorbital foramen

orbit

incisive canal

incisive foramen

anterior nasal spine

nasal cavity

nasal septum

hard palate

maxillary sinus 

floor of maxillary sinus

zygomatic process 

zygoma

hamulus

what are the bony landmarks of the mandible and surrounding structures 

mandibular condyle

coronoid notch

coronoid process

mandibular foramen

lingula

mental foramen

mental ridge

mental fossa

lingual foramen

genial tubercles

inferior border of the mandible

mylohyoid ridge

external oblique ridge

angle of the mandible

what is this, its description and its appearance on images

mandibular condyle

round projection extending from posterior superior border of ramus of mandible

bony rounded radiopaque projection, not seen intraoral

what is this, its description and its appearance on images

sigmoid notch

curved depression between mandibular condyle and coronoid process of mandible

radiopaque, not seen 

what is this, its description and its appearance on images

coronoid process

thin prominence shaped like crows beak 

radiopacity, may be seen on maxillary molar periapical image 

what is this, its description and its appearance on images

mandibular foramen

round hole on lingual aspect of ramus mandible

radiolucent, not seen intraoral

what is this, its description and its appearance on images- 1st line

lingula

small tongue shaped projection seen adjacent to mandibular foramen

radiopacity, not seen intraoral

what is this, its description and its appearance on images

mandibular canal

tubelike passageway thru bone that travels within body or length of mandible

radiolucent band outlined by two thin radiopaque lines representing cortical walls of cancal, may be seen on intraoral 

what is this, its description and its appearance on images

mental foramen

hole on external surface of mandible region

round radiolucency in apical region of mandibular premolars, may been seen intraoral

what is this, its description and its appearance on images- 9 

hyoid bone

horseshoe shaped bone below mandible, between chin and thyroid cartilage

floating curved radiopacity, not seen intraoral 

what is this, its description and its appearance on images

mental ridge

im not writing all that

radiopaque band that extends from mandibular premolar region to incisor region, may been seen 

what is this, its description and its appearance on images

mental fossa

radiolucent area above mental ridge, may be seen 

what is this, its description and its appearance on images

lingual foramen

tiny hole in internal surface of mandible near midline

small radiolucent dot located inferior to the apices of mandibular incisors, may be seen 

what is this, its description and its appearance on images

genial tubercles

tiny bumps of bone located on lingual aspect of mandible

ringshaped radiopacity surrounding lingual foramen, may be viewed

what is this, its description and its appearance on images

inferior border of mandible

thick linear prominence of cortical bone that defines lower border of the mandible

radiopaque band outlines the lower border, may be seen

what is this

mylohyoid ridge

what is this

internal oblique ridge , may be seen

what is this

external oblique ridge, may be seen

what is this,

angle of mandible , not seen

what are the air spaces seen on panoramic images

palatoglossal

nasopharyngeal 

glossopharyngeal 

where is the palatoglossal air space

between palate and tongue

where is the nasopharyngeal air space

pharynx posterior to cavity

where is the glossopharyngeal air space

pharynx located posterior to tongue and oral cavity

what soft tissues are seen on panoramic images

tongue

soft palate and uvula

lip line

ear