Because panoramic radiographs are “Mercator” projections of the area of interest, it is challenging to accurately assess the anatomic area being imaged, but because pantomography has been around for a long time and the focal trough and technique have evolved over time, the depiction of joint anatomy is now well understood. Soft tissue components of the TMJ are not captured adequately, and direct visualization of these structures is not possible, as on any other conventional 2D radiographs. Variable magnification of the images in all three axes has been documented to severely impair the ability to make measurements for diagnosis or for treatment planning purposes. Alterations in imaging geometry have been implemented in some panoramic units to limit exposure to the TMJ. The patient’s position in the focal trough of the panoramic unit, as well as the choice of imaging parameters such as the configuration of the focal trough itself, are of paramount significance in this context to reduce uneven magnification of the areas of interest. 11,12 However, this view allows bilateral visualization of both TMJs, enabling a reasonable comparative evaluation. The inherent distortion, magnification, presence of superimposing ghost artifacts, double shadows, and so on prevent a thorough and quantitative examination of the osseous components of the TMJ. Panoramic radiographs are used as screening images to evaluate the TMJ. Fonseca DMD, in Oral and Maxillofacial Surgery, 2018 Panoramic Radiography

Panoramic radiograph scan cdr dicom