EVALUATION OF PATIENT PREPARATION AND POSITIONING ERRORS ON DIGITAL PANORAMIC RADIOGRAPHS

Dental panoramic radiograph, in addition to clinical examination, is a valuable diagnostic tool for the dentist to obtain information. Quality of each radiograph is of supreme importance. Unsatisfactory quality of radiograph can lead to misinterpretation that may result in inadequate diagnosis and treatment plan. Good quality radiograph will avoid any further need of repeating radiograph, thus reducing any unnecessary exposure of ionizing radiation to the patient. The objective of this study was to determine the relative frequency of common preparation and positioning errors observed on dental panoramic radiographs & to assess quality of radiographs as well. Dental panoramic radiographs were obtained from pretreatment records of patient undergoing orthodontic treatment & each radiograph was assessed for preparation and positioning errors. A three point quality scale proposed by National Radiological Protection Board was used by the examiner to rate each radiograph as being excellent, diagnostically acceptable or diagnostically unacceptable. Out of 480 panoramic radiographs examined, 100 (21%) radiographs were free from any type of preparation or positioning error while 380 (79%) radiographs had some preparation or positioning errors. The most frequent preparation error observed was patient wearing nose pin (8.3%). While the most common positioning error observed was patient’s failure to position tongue against the palate (62.5%). More than one positioning or preparation error was found in 41.6% of the faulty radiographic films. Only 21% of radiographs were rated excellent, 64.5% were diagnostically acceptable, and 14.5% were unacceptable. Quality of panoramic radiograph must be assessed regularly making sure that they are free of any preparation or positioning error. All dental professionals must identify patient preparation and positioning errors and must understand consequence of these errors on diagnostic yield of radiograph.