Justification of full width panoramic radiography in Oral Surgery

Objective: How much of a full width panoramic radiograph is required for diagnosis and treatment planning in Oral Surgery? Study design: In this retrospective study, the panoramic radiograph was divided into five equal vertical segments and assessed as to the number of segments required for diagnosis and treatment planning in relation to their initial referral. Incidental findings outside the areas required were investigated as to whether or not they influenced treatment planning. Results: From images of 823 patients; over half (56.5%) required only one segment of the image for diagnostic purposes in relation to their referral. The posterior mandible and temporomandibular joint areas were required least (5.3%), followed by the midline segment (10.0%). The segments required most often were the molar and premolar regions bilaterally (84.7%). In 15.8%, incidental findings were observed outside of the segments requested, but these only influenced treatment planning in 2.9% of cases. Conclusion: In this study of patients attending an oral surgery service, a full width panoramic tomograph was not required in most instances. Referrals for segmental panoramic imaging should be regarded as regular rather than unusual practice.