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Rotational panoramic radiographs-unusual triple images
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Valai-Kasim, Shakeel-Ahmed; Krishnaswamy, Nathamuni-Rengarajan; Biju, Tom; Thavarajah, Rooban
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This document is a artículoDate2015
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Currently clinicians advice rotational panoramic radiography (RPR) for preliminary investigation. Despite few
inherent limitations, rotational panoramic radiography still remains the diagnostic tool of choice. Abnormal structures such as a supernumerary tooth or a device falling within the certain central regions in conventional RPR images
may mislead the clinicians towards an inaccurate diagnosis by producing multiple ghost images. Such cases must
be treated with circumspect, and apart from RPR, additional imaging modalities need be employed to provide a
judicious interpretation of the clinical situation.
Thus this manuscript, we present a case where a paramedian supernumerary tooth which exhibited double ghost
images on a conventional RPR. This prompted us to elicit the use of a CBCT and 3 dimensional images to determine the true nature of the problem. We outline the working of the diamond principle behind a conventional RPR
which cause the appearance of multiple ghost images. The discerning clinician must be cognizant of the possible
positional and analytical errors which may be prevalent in a conventional RPR when viewing structures lying in the
palatal region, specifically in the midline while making diagnosis.
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