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The truth behind the lines - an update on dental panoramic tomograms reporting for general dental practitioners

British Dental Journal volume 238, pages 706–713 (2025)Cite this article

Abstract

This article underscores the need for comprehensive interpretation of dental panoramic tomograms (DPTs), emphasising the significance of dental anatomy and broader head and neck structures. While general dental practitioners (GDPs) commonly use DPTs for diagnosing dental pathology, there is a tendency to focus solely on the dentition, overlooking information related to head and neck anatomy. The potential medico-legal consequences associated with incomplete reporting make a thorough assessment imperative. The article introduces ‘the Heath-MacLeod technique' for reporting, outlining a systematic approach to ensure all aspects are considered. This stresses the importance of a holistic approach to DPT interpretation using a ‘radiological sieve', improving patient care and reducing the risk of misdiagnoses and legal consequences.

This article is for GDPs on the wealth of anatomy of the maxillofacial region as seen on a DPT and discusses technical errors and examples of pathology. This in turn will provide a foundation of knowledge, allowing for a robust reporting technique, ensuring no clinical information is missed. This not a comprehensive analysis of pathology seen on a DPT but introduces concepts which will allow safe reporting. The reader should be able to analyse the key anatomy seen on a DPT, its presence or absence and how this applies to the holistic management of the patient.

Key points

  • Providing general dental practitioners with the knowledge to be able to report and interpret all the information seen on an orthopantomogram, without just looking at the teeth.

  • Empowering general dental practitioners to be able to refer anatomical variants or potential pathology to the relevant departments from a position of knowledge.

  • Learning and practising the implementation of the ‘STOP' mnemonic for the interpretation of all radiographs in tricky situations.

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Authors and Affiliations

  1. Dental Core Trainee, Department of Oral and Maxillofacial Surgery, Queen Victoria Hospital, United Kingdom

    Jay-Krishan Pandya

  2. Consultant in Dental and Maxillofacial Radiology, Department of Radiology, Newcastle Dental Hospital, United Kingdom

    Neil Heath

Authors
  1. Jay-Krishan Pandya
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  2. Neil Heath
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Contributions

Both authors (JKP and NH) are equally responsible for conceptualisation, preparation of the manuscript and collation of images/data.

Corresponding author

Correspondence to Jay-Krishan Pandya.

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The authors declare no conflicts of interest. Consent has been acquired for use and publication of all clinical photographs/radiographs used in this article. Unless stated otherwise, all clinical images and radiographs have been provided by the authors for patients they have encountered.

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Pandya, JK., Heath, N. The truth behind the lines - an update on dental panoramic tomograms reporting for general dental practitioners. Br Dent J 238, 706–713 (2025). https://doi.org/10.1038/s41415-025-8489-6

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