Types of Panoramic Images

Single Real Image

Double Real Image

Ghost Image

Panoramic Anatomy

Single Real Image

Only one image results from a given anatomical structure. The structure is located between the rotation center and the film and the x-ray beam only passes through the structure one time. Most images seen on a panoramic film are of this type.

Double Real Image

Two images of a single object are seen on the film. Double real images are produced by structures located in the midline. The x-ray beam passes through these objects twice as the tubehead rotates around the patient. Structures that result in double real images are the hard and soft palates, the hyoid bone and the cervical spine.

Ghost ImageGhost images are formed by dense objects located between the tubehead and the rotation center. These ghost images usually result from external objects such as earrings, but they may be produced by dense anatomical structures such as the mandible.

ghost image of earring(between lines)

2423

28

18

17

1914

1315

20

8

10

97

29

37

38

33

30

39

3

5

11

21

6

1

1216

31

3225

4

26

34

35

36

22

2

4144

43

42

27

40

Panoramic AnatomyThe numbers on the diagram below and on the next slide (air spaces) correspond to the numbers on the key (slide 9).

46

45 47 45

Air Spaces

Panoramic Anatomy Key 1. maxillary sinus 2. pterygomaxillary fissure 3. pterygoid plates 4. hamulus 5. zygomatic arch 6. articular eminence 7. zygomaticotemporal suture 8. zygomatic process 9. external auditory meatus10. mastoid process11. middle cranial fossa12. lateral border of the orbit13. infraorbital ridge14. infraorbital foramen15. infraorbital canal16. nasal fossa17. nasal septum18. anterior nasal spine19. inferior concha20. incisive foramen21. hard palate22. maxillary tuberosity23. condyle24. coronoid process

25. sigmoid notch26. medial sigmoid depression27. styloid process28. cervical vertebrae29. external oblique ridge30. mandibular canal31. mandibular foramen32. lingula33. mental foramen34. submandibular gland fossa35. internal oblique ridge36. mental fossa37. mental ridges38. genial tubercles39. hyoid bone40. tongue41. soft palate42. uvula43. posterior pharyngeal wall44. ear lobe45. glossopharyngeal air space46. nasopharyngeal air space47. palatoglossal air space

9

525

28

14

33

12

18

17

19

13

22

7

39

6

33

255

28

9 12

14

18

17

19

22

13

7

6

39

8

20

1115

116

3

30

44

32 23

2

31

26

38

34

24

8

20

1115

1

2

3

30

44

32 23

31

38

34

16

24

26

4

36

36

40

43

43

42

42

4121

40

2146

46

41

45

45

47

47

28

17

44

43

20

2R L

36

41

38

7

11

1

43

47

46

45

R L

2 8

19

17

18

6

16

21

Red arrows point to ghost image of hard palate

23

39

R L

33

8746

47

E

E = epiglottis

R L

3

30

9

27

1

16

44

20

36

42

10

G

G = ghost of right mandible

R L

7

27

26

24

22

38

30

R L

ghost of mandible

47

45

10

6

5R L

7

39

15

21

239

30

Note the relatively inferior location of the mandibular canal (30), providing plenty of room for the implant.

R L

5

44

Ghost images of earrings

15 2R L

Ghost images of earrings

R L