Panorex

The Panorex, also known as a panoramic radiograph, is a type of dental radiography that captures the entire dentition, alveolar bone, and surrounding structures in a single image. This imaging technique is widely used in dentistry and oral and maxillofacial surgery for diagnostic and treatment planning purposes.

History

The development of panoramic radiography began in the early 20th century, with significant advancements occurring in the 1950s. The Panorex machine, a specific brand of panoramic radiograph equipment, was introduced to provide a comprehensive view of the oral cavity, which was not possible with traditional intraoral radiography.

Principle of Operation

Panoramic radiography operates on the principle of tomography, where the X-ray source and the film or sensor rotate around the patient's head in opposite directions. This movement allows for the capture of a wide, continuous image of the dental arches. The technique is designed to focus on a specific plane, known as the focal trough, where the structures are most clearly imaged.

Indications

Panoramic radiographs are indicated for a variety of clinical situations, including:

• Evaluation of impacted teeth, such as third molars
• Assessment of jaw fractures
• Detection of cysts and tumors in the jaw
• Planning for dental implants
• Evaluation of temporomandibular joint disorders
• Assessment of periodontal disease

Advantages

The advantages of using a Panorex include:

• Comprehensive view of the entire mouth, including both jaws and all teeth
• Non-invasive and quick procedure
• Useful for patients who cannot tolerate intraoral films
• Lower radiation dose compared to a full-mouth series of intraoral radiographs

Limitations

Despite its advantages, panoramic radiography has several limitations:

• Lower resolution compared to intraoral radiographs, which may miss small carious lesions
• Distortion and magnification of images, particularly in the anterior region
• Overlapping of structures, which can obscure details
• Limited ability to assess bone density

Procedure

The procedure for obtaining a panoramic radiograph involves the following steps: 1. The patient is positioned in the machine with the help of chin rests, bite blocks, and forehead supports to ensure proper alignment. 2. The patient is instructed to remain still and bite on a plastic bite block to separate the upper and lower teeth. 3. The X-ray source and sensor rotate around the patient's head, capturing the image in a matter of seconds. 4. The resulting image is processed and reviewed by the dental professional.

Safety and Radiation Exposure

Panoramic radiography is considered safe, with radiation exposure levels significantly lower than those of a full-mouth series of intraoral radiographs. However, standard precautions, such as the use of lead aprons and thyroid collars, are recommended to minimize exposure.

Technological Advances

Recent advances in panoramic radiography include the integration of digital radiography systems, which offer enhanced image quality, reduced radiation exposure, and immediate image availability. Digital systems also allow for easy storage and sharing of images.

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