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Panoramic tomography of the maxillofacial region
Last reviewed: 04.07.2025
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A panoramic tomogram (orthopantomogram), which is a type of zonogram, displays the entire dental system. The image is enlarged by 30%.
During the imaging process, the tube and cassette with film and intensifying screens describe an eccentric incomplete circle (about 270') around the patient's motionless head. At the same time, the cassette also rotates around the vertical axis. All this ensures that the X-rays pass perpendicularly (orthoradially) to each examined area of the jaw and the cassette.
The image shows only a certain layer: a thicker section (2-2.7 cm) in the lateral sections, respectively, the area of premolars and molars, and a thinner section (0.4-0.8 cm) in the central section, the image of which is less clear. In order to avoid projection of the cervical vertebrae on the frontal section, the patient's neck should be straightened and even slightly bent forward. The image shows all sections of the lower jaw, the alveolar bay and the relationship of the roots of the teeth with the bottom of the maxillary sinus, elements of the pterygopalatine fossa (the posterior wall of the maxillary sinus and the pterygoid processes of the sphenoid bone). The posterior sections of the sinus are outside the selected layer.
The informative nature of the method allows it to be recommended for injuries and inflammatory diseases, cysts, neoplasms, systemic lesions of the jaws, in people with multiple caries, periodontal diseases, during prosthetics and orthodontic treatment.
To install an orthopantomograph, an area of 20 m2 is required . The device can be installed in a general diagnostic room procedure room with an area of 55 m2.
In panoramic radiography, the anode of a fine-focus tube (focal spot diameter 0.1-0.2 mm) is inserted into the oral cavity, and the X-ray film in a polyethylene cassette with intensifying screens is placed outside. Direct panoramic radiographs produce an image of the upper or lower jaw and dental arch, while lateral ones produce the right or left halves of both jaws.
The method is most informative when examining the frontal sections of the upper and lower jaws. The images of the upper jaw show the relationships of the roots of the teeth and pathological processes with the bottom of the nasal cavity and maxillary sinus. Due to the high radiation load, this method is rarely used at present.
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