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Dentistry-5th semester > Panoramic: > Flashcards

Panoramic: Flashcards

1
Q

“the image layer”/“focal trough”

A

The zone of tissues that will be sharply depicted on the radiograph, and at the same time they will show uniform magnifications

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2
Q

Real Image:

A

A Real Image is an image of an anatomical structure where the structure lies between the roation center and the film.

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3
Q

Ghost image:

A

The Ghost image is the image formed when the structures is between the X-Ray Machine and the rotation center.

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4
Q
A

ghost images, of the rings on both sides Left and right sides

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5
Q
A

The rings that is used for stabilization caused a ghost shadow

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6
Q
A

Double real image of hard palate and yellow is the ghost image of the hard palate as well

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7
Q
A

red->Double real mage of hard palate and

blue->double ghost image of hard palate (we have both real and ghost image bcz hard palate lies in the triangle and the same zone)

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8
Q
A

Real Image is when the structure lies between the roation center and the film.

  • A: We can see that we are starting to make a panoramic radiograph. The panoramic machine rotates from the back to the front (arrow shows roataion) As it rotates structure A will be exposed and will be recorded as a real image, as the machine continues twrd the back, structure B will be exposed (lies b/w rotation center and the film) thus B will be exposed.
  • B: When the machine goes all the way to the other side, structures A and B will be exposed again, structure B first and then A, they will be again seen as real images.

In this case we have double real image because those structures were midline structures.

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9
Q
A

Example of double real image: We can see the spine on the right and left, we can see the airway on both sides as well.

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10
Q
A

Hyoid Bone on both sides (double real image)

  • Panoramic is like splitting the patient’s head in 2 pieces and placing the 2 halfs in contact with one another on the radiographic film.
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11
Q
A

Hyoid bone double real image

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12
Q
A

Double real image of hard palate as seen with the green arrows

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13
Q
A

Soft palate in pink and a continuation of hard palate in yellow (double real image)

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14
Q
A
  • We can see the posterior wall of the airway example of a double real image and
  • we can also see a double real image of the epiglottis
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15
Q
A

double real image of epiglottis

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16
Q
A

Air is visualized here

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17
Q
A

Air is visualized here

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18
Q
A

Air is so strong that we can’t see the bones on the sides

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19
Q
A

The midline line and the laser on the cheek indicates the focal trough line and it’s aligned with the canine

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20
Q

Type of error?

A

Patient is Too Far Forward

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21
Q

type of error?

A

Patient is too far back

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22
Q

type of error?

A

Patient’s Chin Too Far up

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23
Q

type of error?

A
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24
Q

type of error?

A

Patient’s Chin Too Far Down

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25
Q
A

Patient’s Head shifted or titled to the side

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26
Q
A

Patient’s Head shifted or titled to the side

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27
Q

type of error?

A

Patient is Slumped into the Machine

28
Q

type of error?

A

Lead Apron Shadow

29
Q

type of error?

A

Earings, Prosthetic Appliances Etc.

30
Q
A
  • Red: Hyoid bone double real image
  • Green:Epiglottis
31
Q
A
  • Green: upper part of airway
  • Red: Middle Part of the airway
  • Yellow: Hypopahrynx No distinct borders
  • We have air trapped below the tongue
32
Q
A

We can see C2 C3 and C4 from the vertebral body bcz C1 is not really seen

Green we can see the epiglottis

33
Q
A

Shadow of cervical spine bcz the patient Is so slumped to the machine. (bright shadow)

34
Q
A

Shadow of cervical spine bcz the patient Is so slumped to the machine.(bright shadow)

35
Q
A

Sometimes the hyoid bone doesn’t look split and looks as one structure all through

36
Q
A

Very good visualization of the vertebra

37
Q
A

Apron shadow

red->Ear lobe

38
Q
A
  • The orbits are seen in a patient of a small head or of a child
  • Green: external auditory canal
  • red: small canal like structure which is the infra orbital canal which ends In the infra orbiatal canl and holds arteries which are spread to the mid face
39
Q
A

green->infra orbital canal

40
Q
A

Soft tissue of nose

41
Q
A

Zygomatic arch in green , which starts from zygomatic process and ends in the zygomatic process of the temporal bone

Red zygomatic process of maxilla

42
Q
A

Floor of maxillary sinus

43
Q
A
  • Anterior wall of maxillary sinus in yellow
  • And in the back posterior wall maxillary sinus
  • Red floor of maxillary sinus it’s b/w wall of anterior and posterior maxillary sinus
44
Q
A
  • Yellow-> is the double ghost image of the hard palate
  • Green->infra orbital canal
  • red->nasal septum
  • Blue shadow: inferior nasal concae (the only independent bone from the 3 concane)
  • White is the maxillary tuberosity
45
Q
A
  • Red glenoid fossa, sometimes has some sort of curvature and obscure the condylar head
  • Yellow articular eminence which is the anterior end of the glenoid fossa where the mandibular condyle stops aka maximum mouth opening positoin
  • Green mandibular condyle, posterior process of mandibula bone and nested by glenoid fossa
  • Blue condylar neck
46
Q
A

The coronoid process Is the anterior process which is underneath the zygomatic arch it shows only when patient is in maximum opening

47
Q
A

The double real image of tongue, we see it due to the shadow b/w hard palate and tongue

48
Q
A

Periapical radiograph of the above panoramic

Here we could see a fracture on root of tooth 11 which we couldn’t see in the panoramic radiograph

49
Q
A

Here we can see a cystic lesion that we could confuse by the floor of the maxillary sinus but when we did the periapical radiograph we were capable to see that there’s a cystic lesion

50
Q
A

The assessment of an impacted tooth is not complete in panoramic radiograph

51
Q
A

The shape of the mandibular canal is narrowed andwe have loss of cortical canal wrt the impacted teeth

52
Q
A

It helps us determine if the impacted canine is there or not and if it will be erupted, but it can’t identify if it’s palatally or buccally etc.., so we will need to order a CT scan

53
Q

The Good Radiographs for TMJ?

A

CT

If the glenoid fossa is overlapping the condyle in the panoramic radiograph then the TMJ can’t be visualized so we can’t use it for TMJ. We can’t make a full assessment of TMJ only by using a panoramic.

54
Q
A

LARGE mucositis on the left

55
Q
A

mucositis

56
Q
A

TMJ’s are shown here bcz it’s structures are not overlapping.

Misrepresentation:
We can see cystic lesion on the mandibular incisors but when we did a peripapical radiograph as seen below nothing shows we can’t see a cyst. Why did this happen? Due to a concavity above our chin which may be interpreted by the radiograph as a cystic lesion

57
Q

Panoramic Radiography – Diagnostic Efficacy / Accuracy:

A
  • Satisfactory visualization of the entire maxillo-facial region in one image
  • Dental caries diagnosis- only moderate and advanced
  • Diagnosis of periodontal diseases- only moderate and
  • advanced
  • Dental Implants-only for initial screening
  • Impacted teeth- In some cases (for wisdom teeth) not
  • satisfactory for impacted canines
  • Temporo-mandibular joint disorders-only for initial screening
58
Q

What’s The Error?

A

Patient head is tilted to the side Chin is also too far down

Shape and Size of the front teeth are not normal looking, it’s due to the error that the patient is too far forward

59
Q

What’s the error?

A

The patient is slumped into the X Ray machine

60
Q

What’s the error?

What is the consequence of this error in our diagnosis?

A
  1. What’s the error? Patient chin if far up
  2. What is the consequence of this error in our diagnosis?Cuts the apices of the teeth
61
Q

What’s the error?

What is attributed with the wavy appearance on mandibular condyle?

A

Lead apron shadow

What is attributed with the wavy appearance on mandibular condyle?
Due to patient motion

62
Q

What do the arrows show?

A
  • Red:Posterior wall of maxillary sinus
  • Green:Zygomatic process of the maxilla
63
Q

What do the arrows show?

A

Red: Ghost image of the hard palate

Green: Condyle

64
Q

What do the arrows show?

A

Red: Nasal Septum

Green: Naso labial fold

65
Q

What Errors can we see?

A

Chin too far up And

Head shifted to the left side (magnified area)

66
Q

What do the arrows show?

A

Soft tissue of the posterior wall of the airway

67
Q
A

The blue area in the center of patients head is a double zone area so whatever is there will form a double real image

Dentistry-5th semester (9 decks)

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