Panoramic Technique

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Panoramic Technique

• DHY 202 Clinical Dental Hygiene I
• Dental Hygiene Department
• William Rainey Harper College

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Introduction

• All panoramic machines work essentially the same,
  although they vary in appearance.
• Panoramic technique can be described in 5 generic
  steps.

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Steps in Panoramic Technique

• Stand the client upright
• Position clients chin
• Close clients teeth on bite stick groove
• Close the side guides
• Provide client instructions

4
Client Preparation

• Remove metallic other objects from head neck
  region
• Place panoramic lead apron (no thyroid collar)
• Check for interference from bulky clothing

5
Exposure Considerations

• Use next highest kVp setting for any of the
  following client characteristics
• Obese
• Large bone structure

• Use next lowest kVp setting for any of the
  following client characteristics
• Frail or small bone structures
• Edentulous

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Steps in Panoramic Technique
Step 1 Stand Client Upright

• Guide client with gentle hand pressure in small
  of back
• Instruct client to
• Stand erect with shoulders down relaxed
• Position feet as far forward as possible
• Hold machine to avoid falling backward
• Adjust head planes
• Midsaggital perpendicular to floor
• Frankfurt parallel to floor
• Purpose straighten cervical spine

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Stand the Client Upright
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Steps in Panoramic Technique

• Rest chin on chin rest
• Purpose
• Ensure chin is tilted down -4 to -7 degrees to
  counter upward angle of beam
• Support steady client head

Step 2 Position Clients Chin
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Position the Clients Chin
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Steps in Panoramic Technique

• Client bites end-to-end in bite stick groove
• Purpose
• Anterior teeth in anterior part of focal trough
• Separate dentition in the image
• Center client in machine

Step 3 Bite in Groove
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Bite in the Groove
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Focal Trough

• Known as the image layer
• A three-dimensional zone in which structures are
  reasonably well-defined
• Determines where dental arches must be positioned
  to achieve clearest image

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Steps in Panoramic Technique
Step 4 Close Side Guides

• Close side guides against clients temples
• Purpose
• Position posterior teeth in middle of focal
  trough layer on both sides
• Stabilize client head position

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Close Side Guides
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Steps in Panoramic Technique

• Tongue on roof of mouth-swallow or suck cheeks
• Hold still (22 secs.)
• Warn about cassette rotation
• Dont follow machine with eyes

Step 5 Client Instructions
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Client Instructions

• Swallow,
• Hold
• Expose

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Cassette Design

• 5-6 x 12 rigid or flexible

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Cassette Intensifying Screens

• Phosphor crystal on plastic base
• Fluorescence reduces radiation to client
• Fast rare earth/Lanex screens emit green light
• Film and screen must be compatible

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Infection Control Procedures

• Use clean, ungloved hands to handle cassette and
  film
• Use disposable bite stick
• Other infection control procedures (draping,
  disinfecting) if deemed necessary

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The End!