How to achieve a good panoramic exposure: proper steps for taking good panoramic radiographs.
A diagnostic panoramic radiograph is easy to achieve if the proper steps are taken before the exposure. We all know "pans" are technique sensitive because of the narrow focal trough and anything outside this area will appear distorted, blurry or show other artifacts we do not want to see in our radiograph. Patient positioning and following the manufacturer's instructions for your panoramic machine are very important. Make sure all patient contact surfaces are covered with the correct barriers for asepsis.
Below are the steps to help you achieve a diagnostic panoramic radiograph every time:
1. Have the patient remove eyeglasses, removable dentures, partials and all jewelry from the head area including tongue piercings.
2. Place the correct lead shield on the patient.
3. Have the patient stand in front of the unit.
4. Raise or lower the unit so that the proper anterior positioning piece is at the patient is nose.
5. Have the patient grip the handrails and walk into the unit.
6. Have the patient place their front teeth into the notch on the bite block edge to edge.
7. Ask the patient to hold the handles firmly. Have the patient cross their arms on the handles if they have broad shoulders. This will lower the shoulders and allow the unit to clear this area.
8. Have the patient take a step forward to extend the cervical spine. This will help to reduce shadows in the area of the front teeth.
9. Control the mid-sagittal plane by using the light to align the bridge of the nose with the center of the bite block.
10. Control the Frankfurt horizontal plane which runs from the lower left orbit to the upper margin of the external auditory canal (a correct exposure shows a slight smile).
11. Close the temple support.
12. Have the patient swallow to remove air, place the tongue on the roof of the mouth to get it out of the way for better visibility of the apex of the maxillary teeth and close their lips to remove the black shadow.
13. Remind the patient to hold still.
14. Press the exposure button.
Following these simple steps will result in a panoramic radiograph providing the best possible compliance from your patient and great diagnostic detail for the doctor.
Mary Ann Rupertus
Professional Clinical Associate
Mary Ann Rupertus has been with Sirona Dental for 16 years as a clinical-specialist. She graduated from the dental assisting program at Delaware Technical Community College in 1985 and worked chairside as a dental assistant for 13 years in private practice. She is a current member of the ADAA. She may be contacted at MaryAnn.Rupertus(a)sirona.com.
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|Author:||Rupertus, Mary Ann|
|Publication:||The Dental Assistant|
|Date:||Jan 1, 2014|
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