Positioning errors and quality assessment in panoramic radiography
Identifieur interne : 002C91 ( Pmc/Curation ); précédent : 002C90; suivant : 002C92Positioning errors and quality assessment in panoramic radiography
Auteurs : Manu Dhillon [Inde] ; Srinivasa M. Raju [Inde] ; Sankalp Verma [Inde] ; Divya Tomar [Inde] ; Raviprakash S. Mohan [Inde] ; Manisha Lakhanpal [Inde] ; Bhuvana Krishnamoorthy [Inde]Source :
- Imaging Science in Dentistry [ 2233-7822 ] ; 2012.
Abstract
This study was performed to determine the relative frequency of positioning errors, to identify those errors directly responsible for diagnostically inadequate images, and to assess the quality of panoramic radiographs in a sample of records collected from a dental college.
This study consisted of 1,782 panoramic radiographs obtained from the Department of Oral and Maxillofacial Radiology. The positioning errors of the radiographs were assessed and categorized into nine groups: the chin tipped high, chin tipped low, a slumped position, the patient positioned forward, the patient positioned backward, failure to position the tongue against the palate, patient movement during exposure, the head tilted, and the head turned to one side. The quality of the radiographs was further judged as being 'excellent', 'diagnostically acceptable', or 'unacceptable'.
Out of 1,782 radiographs, 196 (11%) were error free and 1,586 (89%) were present with positioning errors. The most common error observed was the failure to position the tongue against the palate (55.7%) and the least commonly experienced error was patient movement during exposure (1.6%). Only 11% of the radiographs were excellent, 64.1% were diagnostically acceptable, and 24.9% were unacceptable.
The positioning errors found on panoramic radiographs were relatively common in our study. The quality of panoramic radiographs could be improved by careful attention to patient positioning.
Url:
DOI: 10.5624/isd.2012.42.4.207
PubMed: 23301205
PubMed Central: 3534173
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<author><name sortKey="Raju, Srinivasa M" sort="Raju, Srinivasa M" uniqKey="Raju S" first="Srinivasa M" last="Raju">Srinivasa M. Raju</name>
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<author><name sortKey="Krishnamoorthy, Bhuvana" sort="Krishnamoorthy, Bhuvana" uniqKey="Krishnamoorthy B" first="Bhuvana" last="Krishnamoorthy">Bhuvana Krishnamoorthy</name>
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<author><name sortKey="Dhillon, Manu" sort="Dhillon, Manu" uniqKey="Dhillon M" first="Manu" last="Dhillon">Manu Dhillon</name>
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<wicri:regionArea>Department of Oral Medicine and Radiology, ITS Centre for Dental Studies and Research, Ghaziabad</wicri:regionArea>
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<author><name sortKey="Raju, Srinivasa M" sort="Raju, Srinivasa M" uniqKey="Raju S" first="Srinivasa M" last="Raju">Srinivasa M. Raju</name>
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<country xml:lang="fr" wicri:curation="lc">Inde</country>
<wicri:regionArea>Department of Oral Medicine and Radiology, Teerthanker Mahavir Dental College, Moradabad</wicri:regionArea>
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<author><name sortKey="Verma, Sankalp" sort="Verma, Sankalp" uniqKey="Verma S" first="Sankalp" last="Verma">Sankalp Verma</name>
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<author><name sortKey="Lakhanpal, Manisha" sort="Lakhanpal, Manisha" uniqKey="Lakhanpal M" first="Manisha" last="Lakhanpal">Manisha Lakhanpal</name>
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<author><name sortKey="Krishnamoorthy, Bhuvana" sort="Krishnamoorthy, Bhuvana" uniqKey="Krishnamoorthy B" first="Bhuvana" last="Krishnamoorthy">Bhuvana Krishnamoorthy</name>
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<series><title level="j">Imaging Science in Dentistry</title>
<idno type="ISSN">2233-7822</idno>
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<front><div type="abstract" xml:lang="en"><sec><title>Purpose</title>
<p>This study was performed to determine the relative frequency of positioning errors, to identify those errors directly responsible for diagnostically inadequate images, and to assess the quality of panoramic radiographs in a sample of records collected from a dental college.</p>
</sec>
<sec><title>Materials and Methods</title>
<p>This study consisted of 1,782 panoramic radiographs obtained from the Department of Oral and Maxillofacial Radiology. The positioning errors of the radiographs were assessed and categorized into nine groups: the chin tipped high, chin tipped low, a slumped position, the patient positioned forward, the patient positioned backward, failure to position the tongue against the palate, patient movement during exposure, the head tilted, and the head turned to one side. The quality of the radiographs was further judged as being 'excellent', 'diagnostically acceptable', or 'unacceptable'.</p>
</sec>
<sec><title>Results</title>
<p>Out of 1,782 radiographs, 196 (11%) were error free and 1,586 (89%) were present with positioning errors. The most common error observed was the failure to position the tongue against the palate (55.7%) and the least commonly experienced error was patient movement during exposure (1.6%). Only 11% of the radiographs were excellent, 64.1% were diagnostically acceptable, and 24.9% were unacceptable.</p>
</sec>
<sec><title>Conclusion</title>
<p>The positioning errors found on panoramic radiographs were relatively common in our study. The quality of panoramic radiographs could be improved by careful attention to patient positioning.</p>
</sec>
</div>
</front>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">Imaging Sci Dent</journal-id>
<journal-id journal-id-type="iso-abbrev">Imaging Sci Dent</journal-id>
<journal-id journal-id-type="publisher-id">ISD</journal-id>
<journal-title-group><journal-title>Imaging Science in Dentistry</journal-title>
</journal-title-group>
<issn pub-type="ppub">2233-7822</issn>
<issn pub-type="epub">2233-7830</issn>
<publisher><publisher-name>Korean Academy of Oral and Maxillofacial Radiology</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">23301205</article-id>
<article-id pub-id-type="pmc">3534173</article-id>
<article-id pub-id-type="doi">10.5624/isd.2012.42.4.207</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Positioning errors and quality assessment in panoramic radiography</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Dhillon</surname>
<given-names>Manu</given-names>
</name>
<xref ref-type="aff" rid="A1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Raju</surname>
<given-names>Srinivasa M</given-names>
</name>
<xref ref-type="aff" rid="A2">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Verma</surname>
<given-names>Sankalp</given-names>
</name>
<xref ref-type="aff" rid="A3">**</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tomar</surname>
<given-names>Divya</given-names>
</name>
<xref ref-type="aff" rid="A4">***</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mohan</surname>
<given-names>Raviprakash S</given-names>
</name>
<xref ref-type="aff" rid="A3">**</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lakhanpal</surname>
<given-names>Manisha</given-names>
</name>
<xref ref-type="aff" rid="A1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Krishnamoorthy</surname>
<given-names>Bhuvana</given-names>
</name>
<xref ref-type="aff" rid="A1"></xref>
</contrib>
</contrib-group>
<aff id="A1">Department of Oral Medicine and Radiology, ITS Centre for Dental Studies and Research, Ghaziabad, India.</aff>
<aff id="A2"><label>*</label>
Department of Oral Medicine and Radiology, Teerthanker Mahavir Dental College, Moradabad, India.</aff>
<aff id="A3"><label>**</label>
Department of Oral Medicine and Radiology, Kothiwal Dental College and Research Centre, Moradabad, India.</aff>
<aff id="A4"><label>***</label>
Department of Pedodontics and Preventive Dentistry, IDST Dental College and Research Centre, Modinagar, India.</aff>
<author-notes><corresp>Correspondence to: Dr. Manu Dhillon. Department of Oral Medicine and Radiology, ITS Centre for Dental Studies and Research, Delhi-Meerut Road, Muradnagar-201206, Ghaziabad, Uttar Pradesh, India. Tel) 91-9219-510522, Fax) 91-1232-225380, <email>drmanudhillon@yahoo.co.in</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>12</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="epub"><day>23</day>
<month>12</month>
<year>2012</year>
</pub-date>
<volume>42</volume>
<issue>4</issue>
<fpage>207</fpage>
<lpage>212</lpage>
<history><date date-type="received"><day>12</day>
<month>3</month>
<year>2012</year>
</date>
<date date-type="rev-recd"><day>02</day>
<month>5</month>
<year>2012</year>
</date>
<date date-type="accepted"><day>18</day>
<month>5</month>
<year>2012</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2012 by Korean Academy of Oral and Maxillofacial Radiology</copyright-statement>
<copyright-year>2012</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>
) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><sec><title>Purpose</title>
<p>This study was performed to determine the relative frequency of positioning errors, to identify those errors directly responsible for diagnostically inadequate images, and to assess the quality of panoramic radiographs in a sample of records collected from a dental college.</p>
</sec>
<sec><title>Materials and Methods</title>
<p>This study consisted of 1,782 panoramic radiographs obtained from the Department of Oral and Maxillofacial Radiology. The positioning errors of the radiographs were assessed and categorized into nine groups: the chin tipped high, chin tipped low, a slumped position, the patient positioned forward, the patient positioned backward, failure to position the tongue against the palate, patient movement during exposure, the head tilted, and the head turned to one side. The quality of the radiographs was further judged as being 'excellent', 'diagnostically acceptable', or 'unacceptable'.</p>
</sec>
<sec><title>Results</title>
<p>Out of 1,782 radiographs, 196 (11%) were error free and 1,586 (89%) were present with positioning errors. The most common error observed was the failure to position the tongue against the palate (55.7%) and the least commonly experienced error was patient movement during exposure (1.6%). Only 11% of the radiographs were excellent, 64.1% were diagnostically acceptable, and 24.9% were unacceptable.</p>
</sec>
<sec><title>Conclusion</title>
<p>The positioning errors found on panoramic radiographs were relatively common in our study. The quality of panoramic radiographs could be improved by careful attention to patient positioning.</p>
</sec>
</abstract>
<kwd-group><kwd>Radiography, Panoramic</kwd>
<kwd>Quality Control</kwd>
</kwd-group>
</article-meta>
</front>
<floats-group><fig id="F1" position="float"><label>Fig. 1</label>
<caption><p>The patient's chin is too high, causing a flat occlusal plane, splayed condyles, and loss of sharpness of the maxillary incisors.</p>
</caption>
<graphic xlink:href="isd-42-207-g001"></graphic>
</fig>
<fig id="F2" position="float"><label>Fig. 2</label>
<caption><p>The patient's chin is too low. The occlusal plane is "smiling" and the apices of the mandibular incisors are fuzzy.</p>
</caption>
<graphic xlink:href="isd-42-207-g002"></graphic>
</fig>
<fig id="F3" position="float"><label>Fig. 3</label>
<caption><p>The cervical spine is slumped, appearing as a pyramid shaped opacity, centred at the lower half of the film.</p>
</caption>
<graphic xlink:href="isd-42-207-g003"></graphic>
</fig>
<fig id="F4" position="float"><label>Fig. 4</label>
<caption><p>The central incisors are in front of the bite groove, causing them to appear thin and fuzzy. The cervical spine is in the focal zone, causing it to be superimposed on the mandible.</p>
</caption>
<graphic xlink:href="isd-42-207-g004"></graphic>
</fig>
<fig id="F5" position="float"><label>Fig. 5</label>
<caption><p>The anterior teeth are positioned behind the bite groove causing them to appear wider than normal.</p>
</caption>
<graphic xlink:href="isd-42-207-g005"></graphic>
</fig>
<fig id="F6" position="float"><label>Fig. 6</label>
<caption><p>Panoramic radiograph shows the patient failure to position the tongue against the palate leading to a dark shadow over the maxillary teeth between the palate and dorsum of the tongue.</p>
</caption>
<graphic xlink:href="isd-42-207-g006"></graphic>
</fig>
<fig id="F7" position="float"><label>Fig. 7</label>
<caption><p>Radiograph shows image distortion due to patient movement during exposure.</p>
</caption>
<graphic xlink:href="isd-42-207-g007"></graphic>
</fig>
<fig id="F8" position="float"><label>Fig. 8</label>
<caption><p>The head is tilted to one side, causing one condyle to appear higher than the other and the inferior border of the mandible is slanting.</p>
</caption>
<graphic xlink:href="isd-42-207-g008"></graphic>
</fig>
<fig id="F9" position="float"><label>Fig. 9</label>
<caption><p>The head is turned to one side, causing an asymmetry of the condyles, and wider teeth and ramus on one side than the other.</p>
</caption>
<graphic xlink:href="isd-42-207-g009"></graphic>
</fig>
<table-wrap id="T1" position="float"><label>Table 1</label>
<caption><p>Positioning errors and manifestations on panoramic radiographs</p>
</caption>
<graphic xlink:href="isd-42-207-i001"></graphic>
</table-wrap>
<table-wrap id="T2" position="float"><label>Table 2</label>
<caption><p>Ranking of positioning errors observed on the 1,782 panoramic radiographs examined in the study</p>
</caption>
<graphic xlink:href="isd-42-207-i002"></graphic>
</table-wrap>
<table-wrap id="T3" position="float"><label>Table 3</label>
<caption><p>Quality assessment of 1,782 panoramic radiographs examined in the study</p>
</caption>
<graphic xlink:href="isd-42-207-i003"></graphic>
</table-wrap>
</floats-group>
</pmc>
</record>
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