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What bone might you see on a panoramic radiograph?

Published in Panoramic Radiography 3 mins read

On a panoramic radiograph, you will primarily see the mandible, maxilla, and maxillary sinuses, providing a broad view of these critical structures.

Understanding Panoramic Radiographs

A panoramic radiograph is a specialized dental X-ray that captures a wide view of the jaws, teeth, and surrounding structures in a single image. It utilizes a curved plane tomographic technique to depict these areas, offering an overview that is invaluable for dental diagnosis and treatment planning. This imaging technique is distinct from conventional intraoral X-rays, as it provides a comprehensive image of the entire oral and maxillofacial region.

Key Bones and Structures Visible

While the primary focus is on the upper and lower jaws, a panoramic radiograph encompasses a wider anatomical area, revealing several other bones and anatomical landmarks.

Primary Structures Depicted

These are the main anatomical regions that a panoramic radiograph is designed to clearly depict:

  • Mandible (Lower Jawbone): The entire body of the mandible, including its rami, condyles, and coronoid processes, is visible. This allows for evaluation of the lower teeth, bone density, and detection of fractures, cysts, or tumors.
  • Maxilla (Upper Jawbone): The maxilla, which houses the upper teeth, is extensively shown. This includes the alveolar processes, palate, and portions extending towards the nasal cavity and orbits. It's crucial for assessing impacted teeth, bone levels for implants, and various pathologies.
  • Maxillary Sinuses: These large, air-filled cavities located within the maxilla are clearly outlined. Their visibility is essential for diagnosing sinus infections, assessing the floor of the sinus before dental procedures like implants, and detecting cysts or fluid accumulation.

Other Commonly Seen Structures

Beyond the primary targets, a panoramic radiograph often captures portions of adjacent bones and structures, providing additional diagnostic information:

Bone/Structure Description Diagnostic Relevance
Zygomatic Bones Also known as cheekbones, parts of these bones and their arches are frequently visible, particularly the lateral aspects. Can reveal fractures or anatomical variations in the midface region.
Temporal Bones Specifically, the temporomandibular joint (TMJ) area, where the mandible articulates with the temporal bone, is included. This shows the mandibular condyle and the glenoid fossa of the temporal bone. Essential for evaluating TMJ disorders, assessing joint integrity, and identifying degenerative changes.
Nasal Bones and Cavity Elements of the nasal septum, inferior turbinates, and the inferior border of the nasal cavity can be seen superior to the maxilla. Useful for observing nasal patency, detecting septal deviations, or identifying foreign bodies.
Orbits (Inferior Borders) The lower edges of the eye sockets may be partially captured, especially the orbital rim. While not fully depicted, can sometimes reveal gross pathology or fractures affecting the orbital floor.
Cervical Vertebrae Portions of the upper cervical spine (C1-C3) are often visible in the background, though they can appear superimposed or as "ghost images" due to the imaging technique. Can provide incidental findings of spinal anomalies or calcifications, although detailed spinal assessment requires dedicated cervical spine imaging.
Hyoid Bone This horseshoe-shaped bone in the neck, located above the larynx, may sometimes be seen, though its visibility can vary depending on patient positioning. Rarely of primary diagnostic importance on a panoramic radiograph, but its position can indicate patient positioning issues or, rarely, calcifications.

In summary, a panoramic radiograph offers a comprehensive, two-dimensional view of a wide array of facial bones and structures, making it an indispensable tool in dentistry for initial assessments, treatment planning, and monitoring.