Positioning errors in digital panoramic radiographs: A study

Panoramic radiography is a unique and a very useful extraoral film technique that allows the dentist to view the entire dentition and related structures, from condyle to condyle, on one film. Capturing a wide range of structures on a single film grounds the odds of errors in the digital panoramic radiographs. Improper positioning of the patient complicates it more, reducing the diagnostic usefulness of these radiographs. Wide knowledge about the common positioning errors and the ways to rectify it benefits the dentists in interpretation and diagnosis. Aim: This study is aimed at analyzing the 10 common positional errors (anteriorly positioned, posteriorly positioned, head tilted upwards, head tilted downwards, head twisted to one side, head tipped, overlapping of spine in lower anterior region, tongue not placed close to palate, patient movement, and ghost images) in 200 digital panoramic radiographs selected randomly. Materials and Methods: Two hundred digital panoramic radiographic images of the patients above 6 years of age were selected randomly from the stored data in the system, projected on the white screen, and studied. The radiographs were analyzed by two oral medicine and radiology specialists, by recording separately, and then the results were analyzed. Results: The most common error was failure to place the tongue close to the palate, which leads to the presence of radiolucent airspace obscuring the roots of the maxillary teeth.