'Non-standard' panoramic programmes and the unusual artefacts they produce

Key Points

  • Suggests non-standard artefacts are not widely discussed which may lead to practitioners becoming unsure about them when they arise.

  • Describes two clinical cases and the technical explanation for these artefacts.

  • Provides learning points to improve the readers' clinical practice.

Abstract

Dental panoramic radiographs (DPTs) are commonly taken in dental practice in the UK with the number estimated to be 2.7 million per annum. They are used to diagnose caries, periodontal disease, trauma, pathology in the jaws, supernumerary teeth and for orthodontic assessment. Panoramic radiographs are not simple projections but involve a moving X-ray source and detector plate. Ideally only the objects in the focal trough are displayed. This is achieved with a tomographic movement and one or more centre(s) of rotation. One advantage of digital radiography is hardware and software changes to optimise the image. This has led to increasingly complex manufacturer specific digital panoramic programmes. Panoramic radiographs suffer from ghost artefacts which can limit the effectiveness and make interpretation difficult. Conversely 'conventional dental imaging' such as intraoral bitewings do not suffer the same problems. There are also now several 'non-standard' panoramic programmes which aim to optimise the image for different clinical scenarios. These include 'improved interproximality', 'improved orthogonality' and 'panoramic bitewing mode'.This technical report shows that these 'non-standard' panoramic programmes can produce potentially confusing ghost artefacts, of which the practitioner may not be aware.

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Figure 1: Ghost artefacts on panoramics.
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References

  1. 1

    Hart D, Wall B F, Hillier M C, Shrimpton P C . Frequency and Collective Dose for Medical and Dental X-ray Examinations in the UK. HPACRCE012. 2008. Available at https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/340154/HPA-CRCE-012_for_website.pdf (accessed August 2017).

  2. 2

    Calculated from NRPB data.

  3. 3

    Gulson A D, Knapp T A, Ramsden P G . Doses to Patients arising from Dental X-ray Examinations in the UK, 2002–2004. A Review of Dental X-ray Protection Service Data. HPARPD022. 2007. Available at https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/340122/HpaRpd022.pdf (accessed August 2017).

  4. 4

    Langlais R P . 6 reasons why you should use a panoramic X-ray for bitewings. Dentistry IQ. 2012. Available at http://www.dentistryiq.com/articles/2012/02/6-reasons-why-you-should-use-a-panoramic-x-ray-for-bitewings.html (accessed August 2017).

  5. 5

    Valachovic R W, Douglass C W, Reiskin A B, Chauncey H H, McNeil B J . The use of panoramic radiography in the evaluation of asymptomatic adult dental patients. Oral Surg Oral Med Oral Pathol 1986; 61: 289.

    Article  Google Scholar 

  6. 6

    Terry GL, Noujeim M, Langlais R P, Moore WS, Prihoda T J . A clinical comparison of extraoral panoramic and intraoral radiographic modalities for detecting proximal caries and visualising open posterior interproximal contacts. Dentomaxillofac Radiol 2016; 45: 20150159.

    Article  Google Scholar 

  7. 7

    Kamburoglu K, Kolsuz E, Murat S, Yüksel S, Ozen T . Proximal caries detection accuracy using intraoral bitewing radiography, extra oral bitewing radiography and panoramic radiography. Dentomaxillofac Radiol 2012; 41: 450–459

    Article  Google Scholar 

  8. 8

    Akarslan Z Z, Akdevelioglu M, Güngör K, Erten H . A comparison of the diagnostic accuracy of bitewing, periapical, unfiltered and filtered digital panoramic images for approximate caries detection in posterior teeth. Dentomaxillofac Radiol 2008: 37: 458–463.

    Article  Google Scholar 

  9. 9

    FGDP(UK). Selection criteria for dental radiography, 3rd ed. 2013.

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Acknowledgements

With thanks to E Whaites, M Payne and J Harvey for proof reading

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Correspondence to S. Harvey.

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Harvey, S., Ball, F., Brown, J. et al. 'Non-standard' panoramic programmes and the unusual artefacts they produce. Br Dent J 223, 248–252 (2017). https://doi.org/10.1038/sj.bdj.2017.707

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