Orthopantomography

Question 1. Write a short note on OPG.
Or
Write a short note on the uses of panoramic radiography.
Answer: The full form of OPG is Orthopantomography. It is also called panoramic radiography or rational radiography. Panoramic radiography is a radiographic procedure that produces a single tomographic image of the facial structures including both maxillary and mandibular arches and their supporting structures.

Orthopantomography Indications/Uses

• As a substitute for full mouth intraoral periapical radiographs.
• For evaluation of developmental anomalies and TMJ dysfunction.
• For evaluation of tooth development for children, the mixed dentition and also the age.
• To assist and assess the patient for and during orthodontic treatment.
• To establish the site and size of lesions such as cysts, tumors, and developmental anomalies in the body and ramus of the mandible.
• For follow-up of treatment, the progress of pathology or postoperative bony healing.
• Before any surgical procedures such as extraction of impacted teeth, enucleation of cyst, etc.
• For detection of fractures of the middle third and the mandible after facial trauma.
• To study the antrum, especially to study the flor, posterior, and anterior walls of the antrum.
• Periodontal disease as an overall view of the alveolar bone levels.

Read And Learn More: Orthodontics Question And Answers

Orthopantomography Advantages

• Convenient for the patient and requires very little patient compliance.
• Useful in patients with trismus and gagging problems.
• The time required is minimal compared to a full-mouth intraoral periapical radiograph.
• The patient exposure dose is relatively low compared to full-mouth intraoral periapical radiographs.
• Panoramic radiographs taken for diagnostic purposes are valuable visual aids in patient education.
• The anatomical structures are most identifiable and the teeth are oriented in their correct relationship to the adjacent structures and each other.
• It allows for the assessment of the presence and position of unerupted teeth in orthodontic treatment.
• It demonstrates periodontal disease in a general way. Manifesting a generalized bone loss.
• This view helps in the localization of objects/pathology in conjunction with a topographic occlusal view or an intraoral periapical radiograph.

Orthopantomography Disadvantages

• Areas of diagnostic interest outside the focal trough may be poorly visualized, e.g., swelling on the palate or floor of the mouth.
• This radiograph is of poor diagnostic quality, in terms of magnification, geometric distortion, poor definition, 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.
• The density of the spine, especially in short-necked people can cause a lack of clarity in the central portion of the film.
• The number of radiopaque and radiolucent areas may be present due to the superimposition of real/double or ghost images and because of soft tissue shadows and air spaces.
• Due to prescribed rotation, patients with facial asymmetry or patients who do not conform to the rotation curvature cannot be X-rayed with any degree of satisfaction.
• Artifacts are easily misinterpreted and are more commonly seen, e.g. nose ring as a periapical radiopaque lesion, and earring as a calcification 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.
• The cost of the machine is very high.