Patient-selection criteria for panoramic radiography

The purpose of this study was to determine whether selection criteria could be developed for the use of panoramic radiographs in the treatment planning of patients seeking dental care. A total of 1,424 patients were included in this 10-month study. Clinicians were asked to indicate what signs or symptoms caused them to order a panoramic radiograph. After the radiograph was taken, the referring clinician was asked to indicate the extent that the panoramic radiograph influenced the patient's care. The panoramic examination was found to be most productive in dentulous patients when no other radiographs were ordered and least productive in dentulous patients who had already had a full-mouth set of radiographs. Considering all patients, it is possible to reduce the number of panoramic examinations by 73% while missing 6% of the findings that influence patient treatment. The most important selection criteria for the panoramic examination are whether the radiograph was ordered for a "general screening examination" (a negative predictor) and whether the radiograph was ordered for any specific examination (a positive predictor).