What is orthopantomography - OPT
For orthopantomography or orthopanoramics, or again OPT, we mean a particular type of radiography, for the study of dental arches. It's a real one dental radiography, which includes all the teeth, which is why it is also called dental overview. To perform an orthopantomography you cannot use just any radiographic device, but it is necessary to use aorthopantomograph, that is a device that conveys X-rays from the outside to the inside of the mouth of the patient, where a film or digital detector is placed. This way you get an overview of all teeth, of part of the jaw and of jaw.
This is a test commonly performed in many studies dentists and also in the radiology departments. In this examination, each tooth is identified by dividing the mouth into four quadrants, and giving the teeth a number from one to nine, starting to count from the center. In this way each tooth (or dental element) is indicated schematically and quickly and precisely by a two-digit number.
What is orthopantomography used for
How come yours dentist requested aOPT? What is the orthopanoramic for? The uses of orthopantography are varied. The following are listed indications of this technique. All the terms used are different names for the same exam, the x-ray orthopantomography.
- In the children L' orthopanoramic dental arches allows to study the normal dental rash, evaluating the eruption of the deciduous teeth (commonly called milk teeth) and the gradual transition to permanent dentition.
- In the adult you can use the OPT to search teeth included, that is, not erupted during the juvenile age. When there are any, this examination also allows us to understand if the non-erupted teeth are immediately below the gum, therefore in a superficial position, or inside the bones of the dental arches, in depth. Alternatively, if the teeth are not identified at the OPT, a real situation may arise agenesis, that is one lack of training of the tooth. The dental overview allows you to distinguish all these pictures.
- This exam allows you to view the caries, and it is useful to dentists to confirm the presence of decayed teeth and see additional caries not visible during a visit. Caries appear as alterations of the dentin, the more solid outer layer that covers the crown of the tooth. They can appear both as images white, denser than the surrounding dental crown, than like images more dark, radiolucent, real "holes" in the crowns. With this examination, caries can be precisely located, for example at the level of the crowns or necks of the teeth, and it is also possible to define their severity, based on the depth to which thedental erosion.
- The overview of the teeth allows you to see any cyst that can form around the roots gods teeth. Always around the tooth roots, they can form granulomas, often for infections related to chronic caries, or abscesses, which, on the other hand, are extensive infections, and can manifest themselves with fever and pain, and require antibiotic therapy. It may be useful, in cases of very large formations, to perform a more complex examination, the Dental-TC, to better study the relationships of these pathological formations with the surrounding structures.
- With the OPT the dentist manages to appreciate the mandibular canal, a channel contained injaw bone, below the tooth roots. Contains vases that spray the teeth and inferior alveolar nerves. In the case of large granulomas or abscesses, this canal can be compressed, and the compression on the nerves within it causes intense pain. It is a problem that can be localized with digital orthopantomography. Sometimes some teeth, especially the molars and the so-called teeth of the judgement, they may have their roots close to the mandibular canal. For this reason, in view of any dental removal interventions, it is good to perform an OPT to evaluate the relationship between the teeth and the canal, in order to prevent complications of the intervention.
- After trauma or falls the orthopantomogram allows to highlight any dental fractures, real breakages of the teeth.
- It is useful to scan the teeth even in patients who have had treatments in the past, especially if numerous, to locate them after some time. In fact, it is not always clear or the patients can remember which ones teeth have been treated.
- Dental arch radiography is used for evaluation of the maxilla and mandible in anticipation of installations, and in all cases in which it is necessary to place a dental prosthesis.
- The OPT also allows you to evaluate the outcomes of previous dental treatments.
- It is useful for locating some rare ones tumors that can form in the jaw, in jaw and around tooth roots. In these cases it is usual to perform a dental-CT, after the orthopantomography of the dental arches. In any case, this very complex examination is hardly performed if you have not already done a 'dental orthopantomography, both to limit the administration of unnecessary doses of radiation, which are higher in dental CT than in a common dental panoramic, and because the cost of orthopantomography is lower. Dental-CT is also an examination that may require the administration of contrast medium, involving greater risks in case of any allergies, like all tests with contrast medium.
- The OPTs allow to study the presence or absence of eighths, or third molars, more commonly called "wisdom teeth", And to evaluate their position with respect to the other teeth in the dental arches, in order to understand if they can cause problems, such as disodontiasis, infections, caries or abscesses. Examination is also required if a wisdom tooth needs to be removed in preparation for surgery. In addition, any other supernumerary teeth can also be identified.
- Although it is not the most suitable exam, the OPT allows in some cases to also view fractures of the jaw, usually resulting from trauma. In the panoramas, in fact, the mandibular condyles and the temporomandibular joints. For the study of mandibular problems, however, this examination is usually integrated with radiographs of the bones with projections for the mandible and condyles, which allow a better appreciation of the bone trabeculation. Later it may be necessary to perform other examinations, especially CT, in the case of complex or poorly assessable fractures with x-ray alone.
- The orthopantomography allows to evaluate in a limited way also the surrounding soft tissues there mouth, and it can allow for example to recognize calcifications or stones in the salivary glands such as the submandibular or parotid. Any nearby calcific lymph nodes can also be recognized. Furthermore, above the palate you can see the maxillary sinuses, bony cavities that are part of the upper airways, against which any obstructive processes can be recognized, or the presence of adenomas or calcified formations. All these findings must then possibly be further investigated with different, targeted and more adequate examinations.
Preparation for orthopantomography
To perform the x-ray of the teeth it is not necessary to follow special rules Preparation. It is important that the patient remove any jewelry, earrings or tongue or lip piercings, as well as the dentures. All of these objects can create artifacts that hinder exam evaluation.
How the OPT works: Exam execution
The examination can be performed standing or sitting. Most of the time, patients are asked to remain standing, possibly with the knees slightly bent and the neck straight.
At this point the patient's head is placed below the orthopantomograph, and a disposable device it is placed in the patient's mouth, usually placed between the incisors. At one time these were photographic films that were exposed by X-rays, today digital detectors are used that are able to reconstruct the image.
The patient is asked to remain motionless, to bite the fixation point in the mouth and to hold the closed mouth for about 20-30 seconds, while the X-ray tube rotates around the patient's head. Sometimes to improve image quality, the panning operator may ask the patient to push their tongue against their upper incisors.
There x-ray of the teeth, while being considered a simple, first-level exam, it exposes a small amount of ionizing radiations, or rays X. The dose is lower than that received with a normal X-ray. For this reason, it is an exam that is performed only if necessary in pregnant patients, who will be asked to sign a paper consent. In these cases, the dose absorbed during the examination can be further reduced by having the patients wear a leaded gown.
Is it a painful exam?
The OPT is a short exam, it is neither painful nor invasive. It does not even require the administration of contrast medium.
Cost and prices (public and private)
But how much does a dental panoramic cost? The price of the orthopantomography can vary.
The cost of a dental panoramic varies greatly depending on the center where the examination is performed. In the public, the cost of the ticket is low less than 30 euros. The examination may be covered by the health system in patients with appropriate exemptions, such as E11 for patients under 14 or E02 for unemployed patients.
In private, usually the cost of the orthopantomography is around 70 euros, but it varies in different studios and in different cities / regions.