Stittsville Family Dentist. Panorex x-rays at Capital Smiledocs Dental
What are Panorex x-rays?
As you can see from the image above, the Panorex is a large, single x-ray film that shows the entire bony structure of the teeth and face. It takes a much wider area than any intra oral film showing structures outside of their range including the sinuses, and the Temperomandibular Joints. It shows many pathological structures such as bony tumors and cysts, as well as the position of the wisdom teeth. They are quick and easy to take, and cost a little more than a full series of intraoral films. In addition to medical and dental uses, panoramic films are especially good for forensic) purposes in the identification of otherwise unrecognizable bodies after plane crashes or other mishaps.
Panoramic films differ from the others in that they are entirely extraoral, which means that the film remains outside of the mouth while the machine shoots the beam through other structures from the outside. It fits into a broad category of medical x-rays called tomographs. A tomograph is a computer assisted method of focusing x-rays on a particular slice of tissue and showing that slice on the film as if there were no other structures outside of that slice. It has a number of real advantages over the intraoral variety of film discussed above. Since it is entirely extraoral, it works quite well for gaggers who could not otherwise tolerate the placement of films inside their mouths. The patient stands in front of the machine (pictured on the right), and the x-ray tube swivels around behind his head. Another advantage of the panoramic film is that it takes very little radiation to expose it. The amount of radiation needed to expose a panoramic x-ray film is about the same as the radiation needed to expose two intraoral films (periapical or bitewing). The reason for this is that the film cassette contains an intensifying screen which fluoresces upon exposure to x-rays and exposes the film with visible light as well as x-rays.
The film above is a panoramic view of a child under the age of 12. You can see the adult teeth that are forming underneath the baby teeth. You can also see the adult second molars which are the 4 half formed teeth toward the outside of the film. The fact that the second molars are not yet erupted is the reason a dentist or anthropologist can tell that this child is under the age of 12.
These films have one major disadvantage. The panoramic film is a lower resolution picture than the intraoral films. This means that the individual structures which appear on them such as the teeth and bone) are somewhat fuzzy, and structures like caries (tooth decay) and bony trabeculation (the sponge like bone inside the marrow spaces) are imaged without the fine detail seen on intraoral films. They are not considered sufficient for the diagnosis of decay, and must be accompanied by a set of bitewing x-rays if they are to be used as an aid for full diagnostic purposes. The combination of a set of bitewings and a panoramic film is particularly useful for those patients who are to be referred for orthodontic consult, and for extraction of wisdom teeth.
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