Panoramic radiography, also known as orthopantomography, is a cornerstone imaging technique in modern dentistry.
It offers a comprehensive two-dimensional view of the maxillofacial region, including the teeth, jaws, temporomandibular joints (TMJs), nasal cavity, and maxillary sinuses.
This extraoral technique is invaluable across all dental specialties for diagnosis, treatment planning, and follow-up care.
Applications by Dental Specialty
1. Orthodontics
Panoramic radiographs are indispensable in orthodontics for assessing:
✔ Tooth eruption patterns
✔ Impacted or missing teeth
✔ Jaw development and symmetry
✔ Relationship between dental and skeletal structures
They assist in treatment planning and monitoring of growth-related anomalies.
2. Oral and Maxillofacial Surgery
Surgeons use panoramic X-rays to:
✔ Locate impacted third molars
✔ Diagnose jaw fractures
✔ Assess pathological lesions
✔ Plan orthognathic or reconstructive procedures
The ability to visualize the entire jaw in one image aids in surgical accuracy.
3. Periodontics
Although intraoral radiographs are preferred for fine detail, panoramic radiography provides:
✔ A general overview of alveolar bone loss
✔ Detection of advanced periodontal disease
✔ Assessment of furcation involvements or other bone abnormalities
4. Endodontics
While periapical radiographs are standard in endodontics, panoramic views help in:
✔ Identifying periapical pathologies
✔ Detecting root anomalies or resorptions
✔ Assessing prior endodontic treatments or failures
5. Implantology
Panoramic radiographs provide essential data for:
✔ Bone height and width evaluation
✔ Anatomical landmarks (e.g., mandibular canal, sinus floor)
✔ Initial planning of implant positioning and angulation
While cone-beam CT (CBCT) is more precise, panoramic imaging is still widely used in early stages of planning.
6. Pediatric Dentistry
For children, panoramic radiography helps:
✔ Evaluate the mixed dentition
✔ Monitor development of permanent teeth
✔ Detect supernumerary or congenitally missing teeth
✔ Diagnose pathologies such as cysts or trauma
7. Oral Pathology and Radiology
Panoramic X-rays are essential for the initial screening of:
✔ Cysts and tumors
✔ Jawbone abnormalities
✔ Systemic diseases with oral manifestations (e.g., fibrous dysplasia)
Their wide coverage makes them suitable for identifying asymptomatic lesions.
Advantages of Panoramic Radiography
★ Broad Coverage
Entire maxillofacial region in a single image.
★ Low Radiation Dose
Compared to multiple intraoral images.
★ Quick and Painless
Comfortable and easy for patients.
★ Early Detection
Identifies pathologies not visible clinically.
Limitations
★ Lower Resolution
Not suitable for detecting small carious lesions.
★ Geometric Distortion
Due to the nature of image capture.
★ Superimpositions
Anatomical overlaps may affect clarity.
Conclusion
Panoramic radiography remains an essential tool in dental diagnostics across specialties.
Its ability to deliver a global view of the oral and maxillofacial structures makes it irreplaceable in initial evaluations, treatment planning, and screening of pathologies.
By understanding its scope and limitations, dental professionals can make better-informed decisions and optimize patient outcomes.
Recommended Further Reading
☑ White & Pharoah. Oral Radiology: Principles and Interpretation
☑ Misch CE. Contemporary Implant Dentistry
☑ Newman MG. Carranza’s Clinical Periodontology
☑ Cohen & Hargreaves. Pathways of the Pulp
