Assessment of panoral radiograph quality in a dental treatment center

Purpose: The quality of orthopantogram (OPG) images is primarily a function of patient positioning during image capture. The purpose of the investigation was to evaluate the quality of digital panoral radiographic images obtained by using the same imaging device in a large dental treatment center on the basis of the radiography technician operator securing the image. Materials and Methods: Three hundred OPGs radiographs taken on a Kodak 8000C Digital Panoramic and Cephalometric System device in a large dental treatment center comprised the sample. The most recent OPGs beginning at May 2010 through 2007 were selected for three radiography technicians until subgroups of 100 OPGs per technician were obtained. Each panoral was evaluated by two investigators for 21 OPG image errors. Results: Mean panoral total score was 14.71 and mean grade was 2.41 for the entire sample indicating a “good” quality. Significant differences were found among technicians for 3 of 21 panoral fault variables. The relative contribution to inferior OPG quality was greatest for the following positioning faults in rank order: Gazebo effect (11.3%), condyles pushed out (11.0%), unclear nasal structures (10.0%), airspace over U6s (9.5%), and condyles image top (9.0%). Conclusions: There were no significant differences among technicians for overall quality indicators (total score and grade). However, statistically significant differences among the three technicians were found for image error wide anterior teeth, Gazebo effect, and unclear nasal structures