Panoramic Radiography Or Orthopantomography (OPG) Question And Answers
Write short note on orthopantomography.
or
Write in detail about OPG.
Answer.
Orthopantomography
It is an extraoral radiography technique which images maxilla and mandible in a single film.
Orthopantomography is also known as panoramic radiography.
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Purpose of orthopantomography
It provides the overall view of maxilla and mandible with their supporting structures, it helps in evaluation of following:
- Fractures of jaw
- Impacted, unerupted and supernumerary teeth
- Eruption pattern of teeth
- Cyst and tumors of jaw
- Various endocrine, nutritional and blood disorders in jaws
- Developmental anomalies affecting teeth and jaws
- Temporomandibular joint and maxillary sinus.
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Principle of orthopantomography
- If the film moves at the speed, which follows the moving projection of a certain point, this point will always be projected on the same spot on film and will not appear unsharp.
- In OPG, the film is attached to a rotating system and moves in opposite direction to the beam. The film is given correct speed by apposing this movement with contrary movement relative to the beam.
Orthopantomography Procedure
- Explain the procedure to the patient.
- Make the patient wear a lead apron and remove all objects from the head which will interfere with film exposure, e.g. ear rings, necklace, nose rings.
- Special attntion must be paid for proper positioning of patient along focal trough area.
- Patient is instructed to look straight rather than following movement of tube.
- Patient is positioned such that dental arches are located in middle of focal trough area.
- Mid-sagittl plane is kept perpendicular to flor.
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- Patient back and spine is adjusted in erect position and the occlusal plane adjusted so that Frankfurt plane is parallel to flor done by asking the patient to place central incisor into a notched incisal device using a bite block.
- Mark on fim: Lef and right with lead marker.
- Center the lower border of mandible on the chin rest and is equidistant.
- Instruct the patient to position the tongue on the palate.
- After the exposure is complete, than film is subjected to routine processing.
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Orthopantomography Advantages
- It is a simple procedure requiring very little patient compliance.
- It is convenient for the patient.
- It is useful in patients with trismus and gagging problems.
- Time required is minimal compared to a full mouth intraoral periapical radiographs.
- Portion of the maxilla and mandible lying within the focal trough can be visualized on a single fim.
- Patient dose is relatively low.
- Panoramic radiographs taken for diagnostic purpose are valuable visual aid in patient education.
- Abroad anatomic region is imaged. In addition to the teeth and the supporting structures, the entire maxillary region and the entire mandible extending distally up to the TM joint is visualized.
- Anatomical structures are most identifible and the teeth are oriented in their correct relationship to the adjacent structures and to each other.
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- It allows for the assessment of the presence and position of unerupted teeth in orthodontic treatment.
- It demonstrates periodontal disease in a general way. It also manifests a generalized bone loss.
- All the parameters are standardized and repetitive images can be taken, on recall visits for comparative and research purposes.
- It is very useful for mass screening.
- This view helps in localization of objects/pathology in conjunction with a topographic occlusal view or an intraoral periapical radiograph.
Orthopantomography Disadvantages
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- Areas of diagnostic interest outside the focal trough may be poorly visualized, e.g. swelling on the palate, flor of the mouth.
- Comparatively, this radiograph is of a poor diagnostic quality, in terms of magnifiation, geometric distortion, poor defiition and loss of detail.
- There is an overlapping of the teeth in the bicuspid area of the maxilla and the mandible.
- In cases of pronounced inclination, the anterior teeth are poorly registered.
- Density of the spine, especially in short-necked people can cause lack of clarity in the central portion of the fim.
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- Number of radiopaque and radiolucent areas may be present due to the superimposition ofreal / double or ghost images and because of sof tissue shadows and airspaces.
- Due to prescribed rotation, patient with facial asymmetry or patients who do not conform to the rotation curvature, cannot be X-rayed with any degree of satisfaction.
- If the patient positioning is improper, the amount of vertical and horizontal distortion will vary from one part of the fim to another part of the fim.
- Ease and convenience of obtaining an OPG may encourage careless evaluation of a patient’s specifi radiographic needs.
- Artifacts are easily misinterpreted and are more commonly seen, e.g. nose ring as a periapical radiopaque lesion, ear ring as a calcifiation in the maxillary sinus.
- OPG shows an oblique, rather than true lateral view of the condylar heads and hence, the joint space cannot be accurately assessed.
- Some patients do not conform to the shape of the focal trough and some structures will be out of focus.
- Cost of the machine is very high.
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