An evaluation of image quality for the assessment of the marginal bone level in panoramic radiography. A comparison of radiographs from different dental clinics.

The diagnostic image quality of panoramic radiographs originating from different clinics was examined. Two samples of 98 and 100 radiographs, respectively, were from a department of oral radiology. The radiographs of one of these samples were checked using immediate subjective analysis of the image quality before inclusion in the study whereas the radiographs of the other sample were randomly selected. A third sample consisted of radiographs from 20 randomly selected dental clinics. The subjective overall image quality of the whole panoramic radiograph was classified as adequate, marginal or inadequate. The three observers also assessed the reason for inferior image quality. The overall image quality of the radiographs was better for the checked sample from the department of oral radiology compared to the sample form the 20 dental clinics. The main reason for unacceptable image quality of the radiographs was too low density and/or contrast irrespective of sample. Other faults were incorrect positioning of the patient but in the sample from the 20 clinics improper film handling was also frequent. We conclude that image quality in panoramic radiography can be improved. Improvement of the image quality is a prerequisite if panoramic radiography in the future is to replace the full-mouth examination.