- Doctor should be familiar with recognizable anatomical structures
- The process of obtaining an excellent panoramic film is technique sensitive: head positioning, removal of facial/head jewelry etc.
- Digital radiography offers more options (documentation, measurements, exposure latitude)
When obtaining a panoramic film, one must be aware of the importance of following proper technique and carefully positioning the patient's skull between the X-ray generator and the film. Rotation of the film and radiation source often occurs along a sliding path and radiation exposure time varies between 5 and 20 seconds. Digital radiography offers more options and offers greater exposure latitude. However, panoramic films underestimate the lower jaw bone height and horizontal measurements are also not reliable. In addition, differences towards real measurements are more limited in the posterior areas.
Panoramic films have many positive elements and are widely used. They can reveal intra-osseous lesions or teeth and provide a screening tool for the maxillary sinus and orbit. Often overlooked due to a focus on maxillo-mandibular structures, arterial atheromas in the neck can be seen on panoramic films. In addition, and of practical clinical advantage, they are a useful alternative for patients with severe a gag reflex.