Panoramic Anatomy Modified

7/30/2019 Panoramic Anatomy Modified

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Panoramic Anatomy


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Ghost Image

Ghost images are formed by dense objectslocated between the tubehead and the rotation

center. These ghost images usually result from

external objects such as earrings, but they may be

produced by dense anatomical structures such as

the mandible. (For more information, see self-study module Panoramic Technique).

ghost image of earring

(between lines)


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9

525

28

14

33

12

18

17

19

1322

7

39

6

33

255

28

9 12

14

18

17

19

22

13

7

6

39


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8

20

1115

116

3

30

44

3223

2

3126

38

34

24

8

20

11

15

1

2

3

30

44

32 23

31

38

34

16

24

26

4

36

36


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4121

40

21

46

46

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45

45

47

47


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36

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38

7

11

1

43

47

46

45

R L


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2 8

19

17

18

6

16

21

Red arrows point to ghost image of hard palate

23

39

R L


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9

11

320

R L

How old is this patient?

a. 6-9 years

b. 10-12 years

c. 13-15 years

b. 10-12 years old


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28

17

44

43

20

2

R L


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2

31

transverse foramen

atlas

R L


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15

34

27

6

46

47 19

R L

What head positioning error is seen on this film?

The anterior teeth are positioned in front of the notch in the

bitestick, resulting in the widening of the anterior teeth (the

maxillary central incisors are as wide as the molars).


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15

17

8 1

32

N

N = soft tissue of nose

R L

What head positioning error is seen on this film?

The head is tipped down too much, resulting in shortened

mandibular incisors and a V-shaped mandible.


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40

27

36

E

LN

LN = calcified lymph node

E = epiglottis

R L


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What positioning error is seen on this film?The patients head is turned to the side. Note the width of the

ramus on each side (The red arrows are the same length).

Which direction was the patients head turned (left or right)?

The head was turned to the left, bringing that side closer to

the film and decreasing the width of the ramus on that side.

The green arrow points to the biteblock, centered on the

contact between the right central and lateral incisors.

?

40

2

18

8

45

R L

? Identifies calcification, possibly in carotid or in lymph node


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33

8

746

47

E

E = epiglottis

R L


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3

21

29

32

11

34

The black dots result from static electricity, caused by

removing the film too quickly from the cassette or from the

box of film (creates friction, which results in a static

discharge).

R L

What causes the black dots identifed by the red arrow?

What positioning error is seen on this film?The chin is tipped up too much, giving a more squared off

appearance to the mandible, creating a reverse smile and

causing the hard palate to be superimposed on the roots

of the maxillary teeth.


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3

30

9

27

1

16

44

20

36

42

10

G

G = ghost of right mandible

R L


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14

27

nose

24

47

39

The lead apron was placed too high on the back of the

patients neck.

R L

What caused the white (radiopaque) area indicated by

the red arrow?


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23

26

7

12

air cell

Air cell in zygomatic arch.

R L


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7

27

26

24

22

38

30

R L


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ghost of mandible

47

45

10

6

5R L


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7

39

15

21

239

30

Note the relatively inferior location of the mandibular canal (30),

providing plenty of room for the implant.

R L

5

44


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1

29

31

2426

Pattern on right side of film (patients left) caused by

excessive oil on patients hair.

R L


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red arrow identifies fracture

28

28

7

R L


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Green arrow identifies pseudo-fracture caused by

palatoglossal air space.

Red arrows point to odontogenic keratocyst.

34

44

27

R L


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Ghost images of earrings

R L


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Ghost images of earrings

15 2R L


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Hearing aid (red arrow) with ghost (green arrow).

27

28

28

R L


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Ghost image of metal used to restore left angle of mandible

R L


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Ghost images of mandibles

(dotted line outlines ghost of left ramus-angle over

right side of mandible)

R L


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Identify the anatomical structures

on the following slides.

Slide # 1


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Slide # 1

A

B

C

D

E

F

G

R L

A

B

C

D

E

F

G

Cervical vertebra

External oblique ridge

Zygomatic process

Maxillary sinus Cervical vertebra

Lingula

Zygomaticotemporal suture

Slid # 2


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A

D

E

F

G

H

I

J

K

Slide # 2

C

R B L

AB

C

D

E

F

GH

I

J

K

Ear lobeExternal auditory meatus

Submandibular gland fossa

Nasal septum

Hard palate

Mental foramen

Hyoid boneMandibular canal

Pterygoid plates

Articular eminence

Pterygomaxillary fissure

Slid # 3


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Slide # 3

A

E

D

BCR L

A

B

C

D

E

Palatoglossal air space

Middle cranial fossa

Lateral border of the orbit

Condyle

Mental fossa

Slid # 4


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Slide # 4

K

J

I

H

G

F

E

D

CB

A

L

R L

AB

C

D

E

F

GH

I

J

K

L

Cervical vertebraZygomaticotemporal suture

Zygomatic process

Nasal septum

Inferior concha

Soft tissue of nose

Hard palatePost. wall of maxillary sinus

External auditory meatus

Posterior pharyngeal wall

Mental foramen

Mental fossa

Slide # 5


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Slide # 5

A

I

H

G

F

E

D

C

B

J

R L

A

B

C

D

E

F

G

H

I

J

Glossopharyngeal air space

Styloid process

Nasopharyngeal air space

Pterygoid plates

Condyle

Infraorbital canal

Infraorbital foramen

Soft palate

Mandibular canal

Lingula

Slide # 6


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Slide # 6

A

BC

D

E

FG

Mental foramen

Incisive foramenSoft tissue of nose

Anterior nasal spine

Pterygoid plates

Ear lobeHyoid bone

G

F

E

A

E

D

C

B

R L

The radiolucency (red arrows) seen in the ramus and third

molar area on the patients right side is an ameloblastoma.

(Differential includes dentigerous cyst, radicular cyst, OKC).

Slide # 7


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Slide # 7

D

C

B

ARL

A

BC

D

Posterior border of maxillary sinus

Inferior border of orbitInferior concha

Inferior border of maxillary sinus

The radiolucency (red arrows) seen in the ramus on the

patients left side is a squamous cell carcinoma.

Slide # 8


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Slide # 8

E

DC

B

A

R L

A

BC

D

E

Maxillary tuberosity

Hard palateCoronoid process

Floor of middle cranial fossa

Posterior pharyngeal wall

This child has a condition known as cherubism. The mandibular lesions

involve both rami, extending into the coronoid process (the condyle is

rarely involved). The maxillary lesions are located in the tuberosity

regions, causing anterior displacement of 2nd and 3rd molars.

Slide # 9


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Slide # 9

F

E

D

C

B

A

R L

A

BC

D

EF

Zygomatic arch

External oblique ridgePalatoglossal air space

Soft palate

Pterygomaxillary fissureStyloid process

This patient has multiple supernumerary premolars in the

mandible (#s 21, 28 and 29 were extracted).

Slide # 10


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Slide # 10

F

ED

B

A

CR L

A

B

C

D

EF

Mandibular canal

Soft tissue of nose

Nasal fossa

Hard palate

Mandibular foramenStyloid process

This patient has impacted mandibular third molars that have

migrated up into the coronoid processes. Note also the long,

thin condylar necks and small condyles.

Slide # 11


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Slide # 11

D

CB

E

A

R L

A

BC

D

E

Sigmoid notch

Nasal septumCoronoid process

Articular eminence

Mental foramen(on crest of ridge)

The green arrows identify a calcified stylohyoid ligament. If there is

associated neck pain, the condition is known as Eagles Syndrome

(recent history of neck trauma or surgery) or Stylohyoid Syndrome (no

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Panoramic Anatomy Modified

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