Panoramic Technique Panoramic Technique DHY 202 Clinical Dental DHY 202 Clinical Dental Hygiene I Hygiene I Dental Hygiene Department Dental Hygiene Department William Rainey Harper William Rainey Harper College College
Jan 03, 2016
Panoramic Panoramic TechniqueTechnique
DHY 202 Clinical Dental DHY 202 Clinical Dental Hygiene IHygiene I
Dental Hygiene Dental Hygiene DepartmentDepartment
William Rainey Harper William Rainey Harper CollegeCollege
IntroductionIntroduction
• All panoramic machines work All panoramic machines work essentially the same, although essentially the same, although they vary in appearance.they vary in appearance.
• Panoramic technique can be Panoramic technique can be described in 5 generic steps.described in 5 generic steps.
Steps in Panoramic TechniqueSteps in Panoramic Technique
• Stand the client uprightStand the client upright
• Position client’s chinPosition client’s chin
• Close client’s teeth on bite stick grooveClose client’s teeth on bite stick groove
• Close the side guidesClose the side guides
• Provide client instructionsProvide client instructions
Client PreparationClient Preparation
• Remove metallic & other objects Remove metallic & other objects from head & neck regionfrom head & neck region
• Place panoramic lead apron (no Place panoramic lead apron (no thyroid collar)thyroid collar)
• Check for interference from bulky Check for interference from bulky clothingclothing
Exposure ConsiderationsExposure Considerations
• Use Use next highestnext highest kVp setting for kVp setting for any of the any of the following client following client characteristics:characteristics:• ObeseObese• Large bone Large bone
structurestructure
• Use Use next lowestnext lowest kVp setting for kVp setting for any of the any of the following client following client characteristics:characteristics:• Frail or small bone Frail or small bone
structuresstructures• EdentulousEdentulous
Steps in Panoramic Technique Steps in Panoramic Technique
• Guide client with gentle hand Guide client with gentle hand pressure in small of back pressure in small of back
• Instruct client to:Instruct client to:– Stand erect with shoulders down Stand erect with shoulders down
& relaxed& relaxed– Position feet as far forward as Position feet as far forward as
possiblepossible– Hold machine to avoid falling Hold machine to avoid falling
backwardbackward
• Adjust head planes:Adjust head planes:– Midsaggital perpendicular to floorMidsaggital perpendicular to floor– Frankfurt parallel to floor Frankfurt parallel to floor
• Purpose: straighten cervical Purpose: straighten cervical spinespine
Step 1 : Step 1 : Stand Stand Client Client UprightUpright
Stand the Client UprightStand the Client Upright
Steps in Panoramic TechniqueSteps in Panoramic Technique
• Rest chin on chin restRest chin on chin rest• Purpose:Purpose:• Ensure chin is tilted Ensure chin is tilted
down -4 to -7 degrees to down -4 to -7 degrees to counter upward angle of counter upward angle of beambeam
• Support & steady client Support & steady client headhead
Step Step 2 : 2 : PositioPosition n Client’Client’s Chins Chin
Position the Client’s ChinPosition the Client’s Chin
Steps in Panoramic TechniqueSteps in Panoramic Technique
• Client bites end-to-end Client bites end-to-end in bite stick groovein bite stick groove
• PurposePurpose• Anterior teeth in anterior Anterior teeth in anterior
part of focal troughpart of focal trough• Separate dentition in the Separate dentition in the
imageimage• Center client in machineCenter client in machine
Step 3: Step 3: Bite in Bite in GrooveGroove
Bite in the GrooveBite in the Groove
Focal TroughFocal Trough
• Known as the Known as the image layerimage layer• A three-dimensional zone A three-dimensional zone
in which structures are in which structures are reasonably well-definedreasonably well-defined
• Determines where dental Determines where dental arches must be positioned arches must be positioned to achieve clearest imageto achieve clearest image
Steps in Panoramic TechniqueSteps in Panoramic Technique
• Close side guides Close side guides against client’s templesagainst client’s temples
• Purpose: Purpose: • Position posterior teeth Position posterior teeth
in middle of focal trough in middle of focal trough layer on both sideslayer on both sides
• Stabilize client head Stabilize client head positionposition
Step 4: Step 4: Close Close Side Side GuidesGuides
Close Side GuidesClose Side Guides
Steps in Panoramic TechniqueSteps in Panoramic Technique
• Tongue on roof of Tongue on roof of mouth-swallow or suck mouth-swallow or suck cheekscheeks
• Hold still (22 secs.) Hold still (22 secs.) • Warn about cassette Warn about cassette
rotation rotation • Don’t follow machine Don’t follow machine
with eyeswith eyes
Step 5: Step 5: Client Client InstructioInstructionsns
Client InstructionsClient Instructions
• Swallow, Swallow,
• Hold Hold
• ExposeExpose
Cassette DesignCassette Design
• 5-6” x 12” 5-6” x 12” rigid or rigid or flexibleflexible
Cassette Intensifying ScreensCassette Intensifying Screens
• Phosphor crystal on plastic basePhosphor crystal on plastic base
• Fluorescence reduces radiation to Fluorescence reduces radiation to clientclient
• Fast rare earth/Lanex screens emit Fast rare earth/Lanex screens emit green lightgreen light
• Film and screen must be compatibleFilm and screen must be compatible
Infection Control ProceduresInfection Control Procedures
• Use clean, ungloved hands to handle Use clean, ungloved hands to handle cassette and filmcassette and film
• Use disposable bite stickUse disposable bite stick
• Other infection control procedures Other infection control procedures (draping, disinfecting) if deemed (draping, disinfecting) if deemed necessarynecessary
The End!