common positioning errors

7/29/2019 Common Positioning Errors

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Panoramic Imaging

Common PositioningErrors,

06-MAY-2009

easonand Correction

Reference Guide to Proper Panoramic Images

1 Jalan Kilang Timor #05-04, Pacific Tech Centre S(159303) TEL +65 6376 0002 .FAX +65 6376 2002.


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Guidelines to Proper Positioning


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Things to Do and Ask

1. Ask all female patient if they are Pregnant

2. To remove all metal artifacts on them

3. If they are having metal fillings or crowns in

e r mou s

4. Ensure their safety and make sure they are

calm

5. Lastly, be confident of positioning the patient


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Physical checks

Lead aprons are to be

worn when exposing

patients. But to note

that the apron does not

goes too high up the

shoulder as it may cause

Remove all earrings and necklaces

As they causes shadows in the images


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Positioning of Patients

1. Make sure the patient hold on to

the handles

2. The patient is tilted alittle towards

the machine

3. Both legs are firmly onto the

ground


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Positioning of Patients

These are very important lights help guide

users to position every patient properly

Frankfurt light

Mid-Sagital light

Canine light


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Ideal Panoramic Radiograph

(a)(c)

(b)

(d)

a. Anterior teeth should be in the middle of image

b. Slight upward or smile line occlusal curve.

c. The condyles are at the same level.

d. Premolars overlapping is normal.


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PANO - Common Positionin Errors


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Patient bites too far forward

1.Anterior teeth are blurred and

minimized.

2.Spine is superimposed over condyles,

This is a common error with edentulous

patients because they have no teeth to

bite on the pin.

Use edentulous bite block for

Focal through too far backward

edentulous patients.

Ask patient not to bite too far forward

and align canine beam exactly.Normal bite block & Edentulous bite block


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Patient bites too far backward

1.Anterior teeth are magnified and

unclear

2.White out caused by ghost image of

cervical spine in the middle and

mandible burn out.

Ask patient not to bite too far backward

and align canine beam exactly.

Focal through too far forward


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Patients head tipped downwards (Chin-down)

1.Upward curvature of occlusal plane.

2.Anterior mandible is distorted and blurred.

3.Mandible is out of focal through.

Up chin rest and align canine beam exactly.


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Patients head tipped upwards (Chin-up)

1.Occlusal plane flattened.

2.Anterior part is blurred.

3.Shadow of the Palate is more prominent.

Down chin rest and align canine beam exactly.


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Patients head tilted

1.Magnification ratio of right and left side looks different.

Patients head tilted up on one side.

Adjust mid sagittal beam correctly.


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Patients head rotated

1.Patients left side is enlarged compared to right.

The patients head was rotated towards the one side.

Adjust mid sagittal beam correctly.


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Patients tongue dropped from palate

1.Large airway shadow directly over the roots of the maxillary teeth

Patients tongue is not being placed on the hard palate during the

exposure.


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Patients head projected

1.White tapered opacity in middle of image.

It is the effect of the spine on the anterior of the image with slumping of

the patient. Ask patients head to be straightened.


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Patients movement

1.Portions of radiograph are blurred.

The patient moves during an exposure. Instruct the

patient to remain still.


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Lead apron artifact

1.Wedge-shaped artifact that also obscures diagnostic

information associated with the mandible

The apron shall not be placed too high up the patients

back prior to exposure.


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Too bright image

1.Image is too bright

Under-exposed.

Increase kVp and mA.


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Too dark image

1.Image is too dark

Over-exposed.

Decrease kVp and mA.


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Summary

With references to the common mistakes we

have seen, we know that it is very important

to know that positioning affects a lot on the

users are able to eliminate such common

mistakes. Therefore Vatech & E-Woo

emphasizes on proper training and promises

to deliver its specialize training to all usersaround the world.


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common positioning errors

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