Benefits of OPG
Diagnose conditions affecting facial bones, teeth and adjacent anatomy (TMJ disorders, bone levels)
orthodontics: anomalies in the number, position, anatomy of teeth, development
Wisdom teeth extractions: impacted third molars
Broad coverage quickly and conveniently achieved
Safe, relatively low dosage compared to full mouth of periodical radiographs
Great for patients with truisms and oro-facial pain that limits their ability to open their mouths
Intra-osseous infections (cysts)
Disadvantages
Cannot provide anatomical detail to the degree of periodical radiographs for caries diagnosis
OPG Operator Instructions
Timeout (check patient’s name, date of birth and address)
Ask about allergies (latex) and possibility of pregnancy. Ask about recent trauma to the face.
Remove all jewellery, piercings, orthodontic appliances and place them into a disposable cup.
Glove up and ask patient over the bite block with plastic sleeve.
Adjust the dosage (child, small adult, medium adult, large adult) settings, occlusion and dental arch (wide, medium and narrow) settings for the patient.
Lower the support section and then ask patient to step forward, bite down on the groove of the bite block and hold the handles.
Ask the patient to swallow, do you feel your tongue
Turn on the laser beam. Adjust the height of the laser so it is at the ala-tragal plane. Ask the patient to shuffle their feet forward so there is no slouching.
Ask the patient to look in the mirror so the laser falls on the vertical line is in the middle of their nose.
Use the clamps on the head.
Exit and instruct the patient to stay still, breathe, swallow and hold their tongue on the roof of their mouth.
Hold the deadman’s switch until the beep disappears.
OPG Analysis of Panoramic faults
Panoramic Fault | Cause | Correction |
Palataglossal air space | tongue is not placed on the roof of the mouth | place tongue on roof of mouth |
Radiolucency covering the crowns of central incisor | lips not closed | close lips |
Magnification of one side | rotation of the head to the other side | tell patient to look in the mirror |
Radiopaque, vertical band in the middle of the OPG | Patient is slouched | tell patient to shuffle their feet forward |
Lower condyle on one side | tilt of the head of the same side | tell patient to look straight ahead in the mirrror |
Flat occlusal plane, maxillary anterior are blurry and wider | chin too high | adjust support bench lower |
Curvy occlusal plane resembling the joker, mandibular anteriors are blurry | chin too low | adjust support bench higher |
Significant anatomy
Inferior alveolar nerve
Ensure inferior alveolar nerve is not overlapping the roots of wisdom teeth
Possibility of an accessory nerve which might impinge the patients
Maxillary sinus
Limit of the maxillary sinus is at the canine
If the maxillary sinus is too low on the bone level, there is a risk of perforation
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