IMAGING MODALITIES AVAILABLE IN DENTAL OFFICES AND CLINICS

Intraoral and Panoramic Radiography
There are a number of imaging modalities that are readily available to the clinician for evaluating patients’ conditions. Virtually every dental office has the equipment to perform intraoral radiography, and many offices also have panoramic x-ray machines. These two types of radiographic equipment will provide the majority of images needed for evaluating patients’ orofacial complaints.

Clinicians who treat patients who have oral medical problems should be able to make a variety of occlusal radiographs in addition to standard periapical and bite-wing radiographs. Occlusal radiographs may be valuable for detecting sialoliths in the submandibular duct, localizing lesions or foreign bodies (by providing a view at right angles to that of the periapical radiograph), and evaluating the buccal and lingual cortex of the mandible for perforation, erosion, or expansion. The advantage of intraoral radiography is the fine detail provided in its visualization of the teeth and supporting bone.
Panoramic radiography demonstrates a wide view of the maxilla and mandible as well as surrounding structures, including the neck, TMJ, zygomatic arches, maxillary sinuses and nasal cavity, and orbits although it does so with less sharpness and detail than are seen in intraoral views (Figure 3-1)
Comparison of right and left sides is easier with a panoramic projection, and this view provides an excellent initial view of the osseous structures of the TMJ and of the integrity of the sinus floor. Additional views targeting these tissues can be obtained later if needed.
Some panoramic x-ray machines also have the capability of providing a variety of skull projections, including lateral, oblique lateral, posteroanterior, anteroposterior, and submentovertex views. Typically, these are done with a cephalometric attachment to the machine. Although these views are relatively easy to take and can provide valuable information in certain circumstances, they demonstrate complex anatomy and should be interpreted by someone with experience in the field, preferably an oral and maxillofacial radiologist.