everything you wanted to know about panoramic . · pdf filepanoramic is part of « image...
TRANSCRIPT
![Page 1: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/1.jpg)
Everything you wanted
to know about
Panoramic Images….
What we can find inside
How to read/decrypt them
SA@MLV
![Page 2: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/2.jpg)
Agenda
o Why a panoramic ?
o Main clinical indications
o Main limitations
o Geometry (positioning)
o Four regions of diagnosis
oMain anatomical landmarks
o Read a panoramic
o Common errors of positioning
o Clinical review
o Artifacts in the image
oGhost images
o Addendum
2
![Page 3: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/3.jpg)
Why a panoramic exam ?
• Often prescribed as an « exploration » first intention procedure.
• A monitoring tool (suivi)
• A screening tool (dépistage)
• Excellent communication mean with patient • easily understood
Because
That image allows a global evaluation of dento-maxilary structures and their
environment.
The panoramic image meets:
• Anatomical logic in its dimensions by placing the dental system in its natural
environment (bone structures, air cavities, soft tissues....)
• Anatomical logic allowing a bilateral, always desirable comparison
• Diagnostic logic, giving advantage to "global" without obscuring the "special"
• Economic logic : low cost, information richness
• Patient safety logic : low x-ray dose
3
![Page 4: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/4.jpg)
Main clinical indications
Assessment of growth and development of children and adolescent to view the mixed
dentition or evaluate third molars.
Dental anomalies (number and shapes)
Dental pathologies (caries and complications)
Impacted teeth and complications
Periodontal diseases (horizontal, vertical bone loss…)
Dental trauma and associated bone lesions
Sinus disorders (pneumatisation, sinusitis, foreign body..)
Evaluation of possible mandibular fractures following trauma to the jaws
Craniofacial anomalies
Evaluation of temporomandibular joint (TMJ) disorders.
4
![Page 5: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/5.jpg)
Main limitations
• Image of superposition : superposed structures (in or outside the focal
trough) can simulate pathologies
• Different enlargement in the image according to the anatomical
localization : no possible precise measurements
• No vestibulo-lingual depth information
• Impacted tooth : vestibular ? Lingual ?
• Position of wisdom teeth roots versus mandibular canal ?
• A vestibulo-lingual angled tooth appears shorter
Glossopharyngal airways
superposed to the ramus
Imitates a bone lesion
5
![Page 6: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/6.jpg)
Geometry : correct image
1. Right-Left symetry: sagital plane splits the anterior teeth
2. TMJ height and vacant space of right and left are equal
3. Occlusal plane is slightly smiling Importance of the FRANKFURT PLANE being horizontal
Refer to indications for positioning the patient correctly in the systems user guides
6
![Page 7: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/7.jpg)
Frankfurt plane
Frankfurt plane
http://conseildentaire.com/wp-content/uploads/2012/06/Plan-de-Franckfort1.png
A line used in anthropometry, which passes from the highest point of the ear canal through to
the lowest point of the eye socket.
Ideal patient positionning for a panoramic procedure means having that plane
horizontal
It means having patient’s head a bit more forward
than the usual head position.
7
![Page 8: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/8.jpg)
Why an horizontal Frankfurt plane ? 1/2
Panoramic is part of « image layer radiography » ; patient’s dental arch must be
positioned within a narrow zone of sharp focus : « image layer » or « focal
trough »
• Objects within the image layer appear sharp
• Objects in front or behind (outside) the image layer are blurred
Anterior area : narrow zone of sharpness, small
tolerance (around 0,5cm)
User must be sure to get anterior dentition (and
specialy teeth apex) inside that focal trough
Posterior area : larger zone of sharpness.
Wider tolerance (around 2cm)
Image layer
8
![Page 9: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/9.jpg)
Why an horizontal Frankfurt plane ? 2/2
That’s the best position to get anterior root apex within the focal trough, thus sharp.
Patient tilted too forward
Lower root apex zone out of focus
Will appear blurred in the image
Patient tilted too backward
Upper root apex zone out of focus
Francfurt plane alignment
Both apex within focus plane
Image layer depth
Bite stick
Below, an illustration of a sagital view of a patient biting stick :
9
![Page 10: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/10.jpg)
Four regions of diagnosis
1 - Maxilar
Nasal structures : bones, turbinates (fossa)
Maxilar bones and sinus
10
![Page 11: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/11.jpg)
Four regions of diagnosis
2 - Teeth and alveolar bone
Teeth, apex
Periodontal bone
11
![Page 12: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/12.jpg)
Four regions of diagnosis
3 - Mandibula
Mandibular bone, rim
Mandibular canals
Foramens
12
![Page 13: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/13.jpg)
Four regions of diagnosis
4 - Temporo-mandibular Joint, including retromaxilar and cervical spine areas
13
![Page 14: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/14.jpg)
Main anatomical landmarks
1 - Maxilar
1-nasal septum, 2-nasal fossa (turbinates), 3-nasal spine, 4-orbital floor,
5-infraborbital canal, 6-wall of maxillary sinus, 7-zygomatic process, 8-zygomatic arch, 9-
hard palate,10-pterygomaxillary fissure, 11-maxillary tuberosity
1 2
3
4
6
7 8
9
6
10
11
4
5
14
![Page 15: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/15.jpg)
Main anatomical landmarks
2 - Teeth and alveolar bone
1-crown, 2-pulp chamber and root canal,
3-periodontal ligament space, 4-lamina dura, 5-incisive foramen,
6-root apex, 7-internal oblique ridge
1
3
4 5
6
2
7
15
![Page 16: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/16.jpg)
Main anatomical landmarks
3 - Mandibula
1-mandibular nerve canal, 2-mandibular foramen, 3-mental foramen
4-genial tubercle, 5-external oblique ridge, 6-ramus, 7-angle of the mandible,
8-inferior border of the mandible, 9-hyoid bone
1
2
3 3 4
5
7
8
6
9 9
16
![Page 17: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/17.jpg)
Main anatomical landmarks
4 - TMJ
1- condyle, 2-glenoid fossa, 3-articular eminence, 4-external auditory meatus, 5-cervical spine
6-hyoid process, 7-ear lobe, 8-mastoid process
1
2
3 4
5
6 7
8
17
![Page 18: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/18.jpg)
Main anatomical landmarks
Air spaces
Nasopharyngeal
Palatoglossal
Soft palate
18
![Page 19: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/19.jpg)
Read a panoramic
1. Assess vertical and horizontal symetry
2. Count the teeth
3. Analyze teeth and anatomic structures from center to outside
4. Examine soft tissues
5. Examine anatomic structures on the edge of the image
19
![Page 20: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/20.jpg)
Common errors
of positioning
![Page 21: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/21.jpg)
Reminder : a good panoramic
21
![Page 22: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/22.jpg)
Patient size (selected) too small
Ramus and condyles are cut verticaly
22
![Page 23: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/23.jpg)
Patient size (selected) too large
+…. Much too spine appears in the image
(+ earrings + patient too forward)
23
![Page 24: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/24.jpg)
Tongue not stuck to palate
All teeth apex of the upper jaw are « burned »
24
![Page 25: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/25.jpg)
Patient twisted (and tilted)
Right ramus and teeth appear larger than on the left side (of the patient)
25
![Page 26: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/26.jpg)
Patient’s head tilted too forward
Condyles are cut horizontaly
Upper anterior teeth are out of focus
26
![Page 27: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/27.jpg)
Patient’s head tilted too forward
27
![Page 28: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/28.jpg)
Patient’s head tilted too backward
Upper anterior root apex are out of focus
28
![Page 29: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/29.jpg)
Patient’s head tilted much too backward,
+ twist
Upper anterior root apex are out of focus
29
![Page 30: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/30.jpg)
Anterior teeth too narrow
Focal trough is located too backward in the jaw
30
![Page 31: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/31.jpg)
Anterior teeth too large
Focal trough is located too forward in the jaw
31
![Page 32: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/32.jpg)
Patient not resting on the chin support
+ Earrings
32
![Page 33: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/33.jpg)
Patient motion
Lateral angulation of anterior teeth
33
![Page 34: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/34.jpg)
Vertical radio opaque strip in the
mandibula
Spine angulation too low
Ask the patient to stretch his neck to a more upright position
34
![Page 35: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/35.jpg)
No bite stick
High risk of being out of focus
35
![Page 36: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/36.jpg)
Patient swallowed during the scan
+ no bite stick
A kind of radiolucent wave through the upper jaw at the apex of teeth
36
![Page 37: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/37.jpg)
Clinical review
![Page 38: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/38.jpg)
Polyp inside sinus
38
![Page 39: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/39.jpg)
Sinusitis, dental origin
39
![Page 40: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/40.jpg)
Chronic sinusitis
Both sinus appear more radio opaque
40
![Page 41: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/41.jpg)
Osteointegration control
This implant is not maintained : failed osteointegration
41
![Page 42: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/42.jpg)
Thin maxilary bone rim
42
![Page 43: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/43.jpg)
Low height of cortical bone rim in the
mandible
43
![Page 44: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/44.jpg)
Osteitis
44
![Page 45: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/45.jpg)
Granuloma or apical cyst
45
![Page 46: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/46.jpg)
Granuloma
46
![Page 47: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/47.jpg)
Lesion in the ramus
47
![Page 48: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/48.jpg)
Orthodontics
Relationship between milk and final teeth
48
![Page 49: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/49.jpg)
Impacted teeth
49
![Page 50: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/50.jpg)
Impacted teeth
50
![Page 51: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/51.jpg)
Periodontic
Horizontal bone loss
51
![Page 52: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/52.jpg)
Wisdom teeth
52
![Page 53: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/53.jpg)
Caries
(+perio vertical bone loss)
53
![Page 54: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/54.jpg)
Missing teeth, agenesy
54
![Page 55: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/55.jpg)
Supernumerary tooth
55
![Page 56: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/56.jpg)
Tooth malposition
56
![Page 57: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/57.jpg)
TMJ pathology
57
![Page 58: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/58.jpg)
Fracture
58
![Page 59: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/59.jpg)
Zygomatic bone consolidation
59
![Page 60: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/60.jpg)
Radicular lyse by internal corrosion
60
![Page 61: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/61.jpg)
Residual rooth apex
61
![Page 62: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/62.jpg)
Rhysalise (root resorption)
62
![Page 63: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/63.jpg)
Radicular fracture
63
![Page 64: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/64.jpg)
Artifacts
![Page 65: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/65.jpg)
Ghost images
sensor
• Some structures/objects are located between the x-ray source and center
of rotation : mandibular ramus, earings (!)…..
• These objects cast ghost images. They appear on the opposite side of the
true anatomic location, and flipped.
• They appear blurred because outside the focal trough
• They are higher in the image than the real object, because of the x-ray
beam upward inclination
earing
Ghost image
of the earing
ramus
Ghost image
of the ramus
Stuart C. White, M.J. Pharoah
65
![Page 66: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/66.jpg)
Ghost images
Example : Mandibular ramus
Real image
Ghost image
Real image
Ghost image
66
![Page 67: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/67.jpg)
Ghost images
Example : Earings
Real image
Ghost image
67
![Page 68: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/68.jpg)
Necklace
68
![Page 69: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/69.jpg)
Lead apron
69
![Page 70: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/70.jpg)
Glasses
70
![Page 71: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/71.jpg)
Gold wires
Plastic surgery
71
![Page 72: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/72.jpg)
Vascular staples
72
![Page 73: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/73.jpg)
Earings + opened lips
73
![Page 74: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/74.jpg)
Earings (big)
Prothesis
74
![Page 75: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/75.jpg)
Maxilo facial surgery
75
![Page 76: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/76.jpg)
Hyoid bone
76
![Page 77: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/77.jpg)
Addendum
Carestream Practical Guide to
Panoramic Imaging
(extract)
![Page 78: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/78.jpg)
78
![Page 79: Everything you wanted to know about Panoramic . · PDF filePanoramic is part of « image layer radiography » ; ... Ghost image of the earing ramus Ghost image of the ramus Stuart](https://reader031.vdocuments.site/reader031/viewer/2022022000/5a7271c57f8b9abb538d8764/html5/thumbnails/79.jpg)
79