Common errors in digital panoramic radiographs

Objectives: To compare errors in digital panoramic radiographs of permanent and mixed dentitions. Methods: 143 and 146 digital radiographs of mixed and permanent dentitions were examined. Results: There were only 2 error-free radiographs in each group. In the mixed dentition group, the mean number of errors per radiograph was significantly lower than in the permanent dentition group (1.74 ± 0.73 and 2.19 ± 0.87 respectively, p = 0.001). Positioning the patient too far forward was significantly more prevalent in the mixed dentition group; slumped position and non-positioning of the chin on the rest were significantly more prevalent in the permanent dentition group. Blurred or shortened upper incisors were significantly more prevalent in the mixed dentition group. Diagnostic ability could be improved by manipulating the brightness or contrast in nearly 45% of all radiographs. In the mixed dentition group, tilting the chin down and a slumped position made the lower incisors to be significantly non-diagnostic. In the permanent dentition group, tilting the chin down made the lower incisors to be significantly non-diagnostic. Conclusions: More errors were prevalent in the panoramic radiographs of the permanent dentitions. Properly positioning the patient is the most important factor in preventing a cascade of errors.