Download - 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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