Image Visibility of Maxillo-facial Fractures in Conventional and Panoramic Radiography

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Abstract
Accurate radiographic diagnosis of fractures in the maxillo-facial region requires series of radiographs exposed in various projections. The greater the number of exposed radiographs, the greater the radiation dose. However, panoramic radiography provides the radiologist with a method giving images which are complete with respect to the jaws and their surrounding structures. The present investigation was performed with the purpose to test the hypothesis that a panoramic radiographic survey image represents the combined information of multiple conventional radiographs. 100 cases of maxillo-facial injuries were studied. The information regarding mandibular fractures was assessed in different projections according to a defined visibility score. It was found that panoramic radiographs were reliable to a great extent. However, in these radiographs the possibilities to determine, for instance, the exact segment displacement was difficult, especially in the anterior and condylar regions. When examining mandibular fractures an appropriate combination of panoramic and conventional radiographs is recommended. This should lead to a decrease in the total number of exposures and, consequently, to a reduction in the radiation dose given to the patient.

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