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Orthopantomography - panoramic x-ray of the maxillofacial region

, medical expert
Last reviewed: 20.11.2021
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The orthopantomogram (OPG) used in dental and maxillofacial radiology is an overview (panoramic) X-ray of the upper and lower jaw, teeth, craniofacial bones and joints, maxillary sinuses and adjacent areas.

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Indications for the procedure

In most cases, this diagnostic method is used by dentists (in the treatment, removal and denture) and specialists in maxillofacial surgery.

Dentists orthopantomogram of teeth is appointed for the purpose of visualizing the entire dental system of patients, giving objective data for assessing her condition. And this ensures the correctness of the diagnosis and the choice of the optimal treatment tactics for the roots of the teeth and their canals, as well as such dental diseases as the basal cyst, periodontitis, periodontitis, etc.

In prosthetics, the orthopantomogram of the jaw or a  panoramic snapshot of the jaw  allows you to clearly determine the degree of periodontal bone loss with an incomplete dentition and choose the most appropriate way to restore it (using removable dental structures, prosthesis or dental implants).

The orthopantomogram of the child can be prescribed by orthodontists during examination during dystopia and retention (impaired eruption) of the teeth, as well as defects in occlusion of the dentition (incorrect bite). Such an X-ray examination is necessary when there is a traumatic injury to the bones of the jaws or if:

Neoplasms of bone tissues of the facial skeleton and jaws (osteoblastoklastomy, osteoma, odontoma, etc.);

Dermoid or bone cyst, cystic form of jaw ameloblastoma;

Congenital defects of the facial skeleton, in particular, craniofacial dysostosis, osteodysplasia, dysraphic syndrome (split upper lip or palate).

Indications for orthopantomography also include diagnostics:

  • osteoarticular lesions of the maxillofacial area of the skull, including dentoalveolar fractures and fractures of the lower jaw;
  • violations of temporomandibular joints;
  • osteomyelitis of the lower jaw and condylar processes;
  • stones of the salivary glands (sialolithiasis);
  • osteosarcoma, osteoradionecrosis and radiation osteomyelitis of the jaw;
  • ameloblastoma;
  • ankylosis of the temporomandibular joint;
  • maxillofacial dermoid cysts (teratom);
  • cysts of the maxillary sinus;
  • calcification and atherosis of the carotid artery.

A dental panoramic radiograph can be used in the diagnosis of ENT diseases, since the apparatus for carrying out this type of radiography captures the frontal sinuses, nasal cavity, part of the pharynx and neck.

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Technique of the orthopantomograms

Preparation for orthopantomographic examination consists in the fact that the patient needs to remove all metal jewelry and jewelery from himself and put on a protective lead vest-apron covering the trunk, including the thyroid gland and neck. Also, the patient eats a small plate connected to the apparatus (in our clinics, the German Orthophos XG devices of various modifications are most often used). It is important to remain completely still during the scan (approximately 18-35 seconds).

A computer orthopantomogram (digital) stores images in the form of files in the patient database (archive) - with unlimited use of them for comparing the results of treatment, and for modeling the performance of various maxillofacial operations.

Normal performance

The orthopantomogram decoding, in which the normal parameters of the dentoalveolar structures are noted and all the anatomical abnormalities and morphological disorders are described, is performed by the x-ray physicians who specialize in dentistry and maxillofacial pathologies.

For example, bone formation of the benign jaw benign nature of the osteoma on the orthopantomogram will look like a segment of densified bone. A cyst looks like a rounded hearth of less dense bone tissue, with clear boundaries.

Harm and irradiation during an orthopantomogram

The standard dose of irradiation during an orthopantomogram is 0.01-0.04 mSv (10-40 μSv). Harm to the body or side effects - if all protective measures are observed - are absent, since the dose of disposable direct ionizing effect on cells is low, and the standards existing in medical radiology allow a maximum radiation load of 1000 μSv for 12 months.

Orthopantomogram has such advantages as full coverage of facial bones and teeth; speed of examination and its convenience for the patient; The possibility of use when restricting the opening of the mouth (for example, due to a spasm of chewing musculature).

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