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A 35-year-old female asked:

Does parnoramic x-ray show all fine fractures or nerve injuries in the upper plate or neck as the result of bad oral surgery?

4 doctor answers8 doctors weighed in
Dr. Ronald Achong
Oral and Maxillofacial Surgery 18 years experience
No: The panorex xray shows fractures of the jaws and large cavities of the teeth. It does not show clearly the fractures of the neck. Xrays of the neck or a ct scan will show fractures of the neck better.
Dr. Sal Aragona
Dentistry 41 years experience
Unlikely: If what you mean by "upper plate" as the upper jaw, maybe. A panoramic x-ray is not a very high resolution type as is the case in cat scans or MRI projections. So, not likely to show all "fine fractures". What makes you think nerve injuries are as the result of "bad oral surgery"?
Dr. Zahid Ahmed
Dr. Zahid Ahmed commented
Dentistry 11 years experience
Agreed. Also, nerve injuries may be simple or complex and a radiograph may not do it. It all depends on what you're looking for.
Apr 26, 2013
Dr. John Scuba
Dr. John Scuba commented
Oral and Maxillofacial Surgery 25 years experience
For most facial and jaw fractures, the panoramic remains a mainstay and the CT scan is useful for some complex injuries of the other areas, like the eye socket, TMJ, cheekbone, etc. MRI is an expensive and relatively useless tool for fractures and bony injury. MRI can show soft tissue (ie nerve) injury, but it is quite difficult to obtain as it takes time in the scanner where the patient must be absolutely still or the image is quite poor. CT is much more straightforward and standard for more involved or complex bony injury. When "bad" surgery of any type is at issue, one should have a frank discussion of concerns with the surgeon. Sounds like that's what may be in play here.
Jun 7, 2013
Dr. John Scuba
Oral and Maxillofacial Surgery 25 years experience
Panoramic: A panoramic film is an excellent screening tool for many fractures. It is not for neck injuries and does not show "nerve injuries"--unless there is an obvious disruption of the lower "nerve canals" on this film. Saw you asked about a #1, so you must mean "upper palate" not "plate". And reference to oral surgery likely means that something is amiss after an extraction. See an oral surgeon.
Dr. Scott Harwood
Oral and Maxillofacial Surgery 45 years experience
No : A panorex will give a 2 dimensional picture of a 3 dimensional object. It is good in detecting certain pathologic conditions but not all.

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Last updated Jun 10, 2014

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