Evaluation of panoramic dental radiographs taken in private practice

Five hundred panoramic radiographs submitted to Delta Dental Plan of Michigan for preauthorization or claim processing were evaluated for frequency of occurrence of 15 categories of technical errors in patient positioning, film processing, and general film handling. Only one radiograph showed no errors. The average radiograph contained 2.2 positioning errors, 1.0 processing errors, and 1.5 miscellaneous errors, for a total of 4.7 errors. Of the 500 radiographs, 467 had positioning errors, 441 had processing errors, and 424 had miscellaneous errors. Diagnostic quality was judged to be adequate in 365 radiographs, inadequate in 91 radiographs and marginal in 44 radiographs. The severity of error was of more importance than the number of errors in the determination of diagnostic adequacy.