Orthopantomography: what is it and what is it for?


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The orthopantomography is a dental diagnostic method that offers the professional a general image of the lower part of the face. Find out here when it is necessary and how it is done.

Today, the orthopantomography is a common diagnostic tool in dentistry. This is an X-ray that provides a detailed view of the lower part of the face.

This radiographic study helps dentists to supplement the information obtained in the clinical examination. In addition, it allows us to detect pathologies that cannot be seen with the naked eye and to plan treatments appropriately.

By providing relevant information about the jaws and teeth, its use is becoming more and more frequent. Read on and learn more about this very important diagnostic method in dental care.

What is an orthopantomography?

The orthopantomography is an extraoral radiographic technique that allows to obtain an image of the lower portion of the face. It has the peculiarity that the receiving film and the X-ray source are outside the patient’s mouth.

The radiographic apparatus performs a synchronous movement around the patient’s head, recording the information on several radiographs. These overlapping plates capture the three-dimensional structures of the face in a single 2D image.

The orthopantomography is also known as panoramic radiography, since in a single general image the upper jaw, mandible and teeth can be seen. It is also possible to visualize the teeth that have not yet erupted and the structures that make up the temporomandibular joint.

In this way, in dental practice, orthopantomography means a complementary diagnostic method that provides valuable information to the professional. It is very useful for detecting lesions in the dental elements, bone conditions, rash problems and disorders of the temporomandibular joint.

These images also allow planning certain therapies such as surgeries, periodontal and orthodontic treatments. At present, it is possible to perform this type of procedure with digital equipment that reduces the radiation dose used.

Features of the orthopantomography

One of the main characteristics of the orthopantomography is that it is an extraoral radiography. Contrary to other conventional dental plates, here the radiographic film is placed outside the patient’s mouth.

To carry out this type of study, a special radiographic device is used that has an arm anchored to a vertical column. The device rotates around the patient’s head. The tube and the plate perform a synchronous movement that allows to register all the facial structures that are scanned, as the device surrounds the person.

Another particular aspect of orthopantomography is the inclusion of several important oral and facial structures in the same radiographic image. It is possible to visualize both dental arches, the maxillary sinuses, the temporomandibular joints on both sides and, although less clearly, some soft structures.

Dental radiography and orthopantomography.
Although the use of radiation with this method is greater than with conventional dental plates, the amount is still negligible.

What are panoramic radiographs for?

The information provided by panoramic radiographs is so complete that its uses are varied. The following are the most common situations in which an orthopantomography can be useful. They are as follows:

  • Dental caries: it is possible to see dark spots that indicate the loss of tooth structure due to caries. Helps identify lesions that are difficult to visualize on clinical examination or that are hidden under restorations. It also determines the extent and depth of the damage and the proximity to the pulp.
  • Bone structure: with the orthopantomography it is possible to know the quantity and quality of the bone structure. Thus, for example, it is possible to observe the loss of alveolar height when there is periodontitis or to analyze the remaining bone that remains after dental extraction and the thickness of the ridges to place implants.
  • Infectious processes: the presence of infections around a tooth or in the thickness of the bone can be observed.
  • Non-erupted teeth: in the orthopantomography not only the teeth present in the mouth are seen, but also those that have not yet erupted and are inside the bone. It is possible to observe the dental germ, the degree of formation of the tooth and its orientation and position. This information is very useful when scheduling surgeries for retained teeth.
  • Dental chronology: observing the erupted teeth and the degree of formation of those that have not yet emerged, the dental age of the patient can be determined; This is an important fact during childhood. In addition, it is possible to monitor the eruptive process to analyze whether it is developing properly.
  • Temporomandibular joint problems.
  • Presence of pathological lesions.

The importance of orthopantomography in treatment planning

In addition to the importance of this radiographic technique for the diagnosis of various pathologies, it is also of utmost importance when planning certain procedures. Having accurate information on the oral structures allows the dentist to decide on the therapies to perform.

In the case of dental cavities, detecting hidden injuries and observing the severity of the injury will help the dentist choose a filling or other type of restoration. Many times it will be necessary to remove old leaked fixes. And if the pulp is compromised, it will be inevitable to choose a root canal.

In patients with gingivitis and periodontal disease, panoramic radiography allows one to see if there are subgingival infections. It can also detect periodontal pockets, dental abscesses and analyze the loss of height of the alveolar bone.

For the placement of dental implants, the use of orthopantomography is essential. This radiographic study allows to analyze the thickness and quality of the bone on which the devices will be placed, the relationship with important anatomical landmarks and to plan the intervention in a precise and safe way.

Panoramic radiographs are also helpful in pediatric patients. Being able to monitor the eruptive process and analyze the characteristics of the jaws as they develop helps to detect problems early. Knowing the anatomical characteristics of the child’s mouth is of utmost importance when planning and designing orthodontic treatments.

How is an orthopantomography performed?

As we have already mentioned, an orthopantomography is performed with special radiographic equipment that rotates around the patient’s head. Carrying out this test is simple, safe and comfortable for anyone.

In general, the procedure is performed with the patient standing, although if necessary, it can be adapted and performed with the person seated. The patient will put on a lead apron as protection and the dentist will show him how to position himself so that the results are optimal.

At the time of the examination, the patient will face the appliance and the dentist will ask him to bite down on a disposable plastic piece that keeps the mouth in the correct position and the dental arches separated. The jaw rests on a projection of the device and the hands will hold two handles that will help the person to be as still and upright as possible.

The machine will rotate around the patient’s head registering facial structures. At present, digital devices are used that reduce the amount of radiation used and allow the image obtained to be viewed on a screen incorporated into the equipment.

The duration of the study is only a few minutes and does not require any prior preparation. During the procedure, the patient does not feel discomfort. You can then go back to your normal daily routine.

Bracket placement planned with an orthopantomography.
The study allows planning long-term treatments, such as orthodontics.

Important clarifications

If a woman knows or suspects that she is pregnant, she should inform the professional conducting the study, as well as the time of gestation. Radiation can be dangerous for the fetus, especially in early pregnancy and when receiving high doses.

The amount of radiation used in orthopantomograms is minimal. However, its use in pregnant women should be limited only to cases where it is very necessary.

If the need for this diagnostic method warrants radiographic taking in a pregnant woman, it should be done with all the care. The belly and neck of the patient should be covered with a leaded apron to protect these sensitive areas.

Ideally, X-rays should be avoided throughout pregnancy, but especially in the first trimester. Well, in this period the vital organs of the baby develop and the risks are greater.

Regarding the use of orthopantomography in pediatric patients, it is also convenient for the professional to analyze the cost-benefit of performing the procedure. Although it is preferable not to expose children to radiation, many times the information provided by these studies allows early treatment of problems that would be complicated if they are allowed to advance.

Considering the low amount of radiation used by new equipment and if adequate protection is used, panoramic radiography can offer valuable information in pediatric dentistry practices. Diagnosing and correcting oral problems early can prevent more serious problems in the future.

It will always be the dentist who will assess the real need for the use of these studies in children. In addition, you will need to consider the possibilities for your little one to help with the test without any hassle.

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As you have seen, the orthopantomography is a quick, comfortable and safe exam. In a short time and in a simple way, it provides valuable information to the professional so that they can make a better approach to oral care.

In addition, the new equipment requires a minimum of radiation to obtain good quality digital images immediately. With low X-ray exposure, the maxillofacial structures of the patient can be generally observed.

Therefore, if your dentist recommends that you take these types of X-rays during your dental appointments, be clear that you will surely obtain benefits. It is a comfortable method for you that will help the professional to give you the best care.

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