THE USE OF PANORAMIC RADIOLOGY IN DENTAL PRACTICE

Objectives: Approximately 1.5 million panoramic radiographs are taken annually in the general dental service in England and Wales. The aim o f this review was to assess the clinical role of panoramic radiology i n the diagnosis of diseases associated with the teeth and to consider its value in routine screening of patients. Method: This was carried o ut by critical review of the literature. Results: In addition to commo n problems with radiographic technique and processing, there are limit ations in image quality inherent to panoramic radiology. These factors contribute to a reduced diagnostic accuracy for caries diagnosis, dem onstration of periodontal bone support and periapical pathology when c ompared with intraoral radiography. Routine screening is unproductive for large proportions of dentate and edentulous populations, while in those cases where pathology is detected the diagnostic accuracy can be questioned. Furthermore, the 'detection' of asymptomatic anomalies ma y have no effect on patient management. Attempts to develop and test p anoramic radiographic selection criteria are reviewed. Conclusion: New , high-yield selection criteria for panoramic radiography are proposed as a means of reducing unnecessary examinations, limiting radiation d oses and reducing financial costs to patients and health service provi ders. However, research is indicated to develop further and to test su ch selection criteria. Copyright (C) 1996 Elsevier Science Ltd.