6 Acquiring PANO Images

■■ Three laser beams, Mid-sagittal plane, Frankfurt plane and Canine, will
be activated to facilitate patient positioning. These beams will disappear
after 20 minutes or if the Ready button is clicked.

The laser beam On / Off icons are located:

-- In the upper right side of the window:

NOTE --
-- On the Touch screen:

■■The scan time and estimated DAP (Dose

Area Product) values will be shown on the
main display for the selected exposure.

J. Guide the patient to the equipment. Position the patient within the equipment.
For further information about patient positioning, refer to section 6.2:
Positioning the Patient.

6.2 Positioning the Patient

Before Positioning the Patient

■■ Ask the patient to remove all jewelry and metallic objects, such as earrings,
hair pins, spectacles, dentures, and orthodontic appliances. These items
may cause shadow images which could obscure diagnosis.

UP
■■ It is strongly recommended that the patient wear a lead apron for protection
DOWN

against any possible scatter radiation.

■■ Adjust the column height to suit the patient using the column up/down
switch.

In general, imaging is performed with the patient in an

upright position.

However, a stool may be used for imaging patients with

NOTE special circumstances. If a stool is used, ensure that the
beams and movement of unit are not obstructed by the
stool

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Correct positioning is an important factor in capturing the

best possible image. Proper positioning will reduce the
NOTE appearance of the cervical spine in the image.

Be careful not to project the laser beams directly into the

patient’s eyes as this could severely damage the patient’s
WARNING
vision.

6.2.1
PANO Standard Mode

Positioning the patient

A. Insert the normal chin support and bite

block into the chin support receptacle on
the equipment.
Hygiene cover

B. Place a hygienic cover over the bite

block.
Bite block

Chin support: Normal * For patients who lack teeth, use the
edentulous chin support. Refer to section
3.3.3: Components and Positioning
Accessories.

The hygiene cover for the bite block is intended for single
use only. Always replace the hygiene cover for each new
WARNING
patient.

Disinfect the chin support and bite block using an alcohol-

based cleaning solution and wipe away all residue with dry
CAUTION
cloth.

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C. Loosen the Temple Supports by turning

the Temple Support Wheel.

Temple support wheel

D. Guide the patient —facing the chin support — to the equipment.

E. Adjust the height of the column using

the column up/down switch until the
patient’s chin rests comfortably on the chin
support.
Column up/down switch UP

DOWN

F. Ask the patient to:

■■Stand upright

■■Firmly grip the handle

■■Lean his/her chest lightly against the

equipment

■■Position his/her feet slightly forward

G. Ensure that the patient’s shoulders

remain level and that his/her neck is
relaxed. The cervical spine should be
straight and upright.

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H. Have the patient bite the bite block

along its grooves using his/her upper and
lower incisors (for edentulous patients, use
the edentulous chin support).

I. Have the patient

■■Close his/her lips around the bite block

■■Keep his/her tongue pressed against

his/her palate

■■Close his/her eyes

Ask the patient to remain still until
scanning is completed.

To acquire the best image possible, ask the patient not to:

CAUTION -- Breathe or swallow saliva during image acquisition

-- Move during image acquisition

Aligning the Laser Beams

Clicking on the Confirm button after setting the parameters

for imaging will activate the three laser beams (Mid-sagittal
plane, Frankfurt plane and Canine) to facilitate patient
alignment. The beams will disappear after 20 minutes or if
the ‘Ready’ button is clicked.
NOTE

To turn the laser beams on or off, click the icon on the

touch screen or the icon on the imaging GUI.

Be careful not to project the laser beams directly into the

patient’s eyes as this could severely damage the patient’s
WARNING
vision.

A. Mid-sagittal plane laser beam: Position the Mid-sagittal plane laser beam
on the center of the patient’s face to prevent magnifications of the left or right
side in the final image.

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B. Frankfurt plane laser beam: Position the patient’s head so that the
Frankfurt plane is aligned with the Frankfurt plane laser beam.

* The Frankfurt plane is the plane which joins the infra-orbital point to the
superior border of the external auditory meatus.

Mid-sagittal plane
laser beam

Frankfurt plane laser

beam

Canine laser beam

Frankfurt plane laser beam lever

C. Canine laser beam: Have the patient smile to properly position the canine
laser beam on the center of the patient’s canine tooth. Rotate the thumb wheel,
located under the patient support rest, forward or backward to properly align the
beam.

Canine laser beam

Canine laser beam lever

Completing Patient Positioning

A. After confirming patient positioning and beam alignment, adjust the temple
supports to fit snugly on both sides of the patient’s head using the temple
support wheel. The temple support wheel is located at the front of the patient
support rest.

B. Click the Ready button on the GUI or touch screen after the patient has been
properly positioned. No X-Ray will be emitted at this point. The rotating unit will
then move into position for imaging.

C. Proceed to section 6.3: Initiating X-Ray Exposure.

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6.2.2
TMJ Open Mode

There are two TMJ sub modes: TMJ Open and TMJ Close. You may scan a
TMJ Close Image subsequent to a TMJ Open image. To prepare and position
the patient, follow the process outlined below.

-- Correct positioning is an important factor for image

capturing. Proper positioning will reduce the appearance
of the cervical spine in the reconstructed image.
IMPORTANT
--
-- For a child with a large head circumference, Man/Woman
mode may be selected instead of Child.

Positioning the patient

A. Insert the TMJ chin support.

CAUTION

Disinfect the chin support using an

alcohol-based cleaning solution and
wipe away all residues with dry cloth
before proceeding any further.

B. Loosen the Temple Supports by

turning the Temple Support Wheel at the
rare of the patient support table.

Temple support wheel C. Guide the patient —facing the chin

support — to the equipment.

D. Adjust the height of the equipment using the column up/down switch until the
patient’s chin is resting on the chin support. Ensure that the chin is in contact
with the chin support.

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E. Ask the patient to:

■■ Stand upright

■■ Firmly grip the handle

■■ Lean his/her chest lightly against the equipment

■■ Position his/her feet slightly forward.

F. For TMJ Open imaging, have the

patient:
Patient position with
chin support ■■Open his/her mouth as wide as possible

■■Keep his/her tongue positioned towards

the palate

■■Breathe through his/her nose

■■Close his/her eyes.

The top of the TMJ support and the patient’s acanthion point must remain in contact
at all times during exposure.

G. Ensure that the patient’s shoulders remain level and that his/her neck is
relaxed. The cervical spine should be straight and upright.

H. Ask the patient to remain still until scanning is complete.

To acquire the best image possible, ask the patient not to:

CAUTION -- Breathe or swallow saliva during image acquisition

-- Move during image acquisition

Aligning the Laser Beams

Clicking on the Confirm button after setting the parameters

for imaging will activate the three laser beams (Mid-sagittal
plane, Frankfurt plane and Canine) to facilitate patient
alignment. The beams will disappear after 20 minutes or if
NOTE the ‘Ready’ button is clicked. To turn the lasers on or off,

click either the icon on the touch screen or the

icon on the imaging GUI.

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Be careful not to project the laser beams directly into the

patient’s eyes as this could severely damage the patient’s
WARNING
vision.

A. Mid-sagittal plane laser beam: Position the Mid-sagittal plane laser beam
at the center of the patient’s face to prevent magnifications of the left or right
side in the final image.

B. Frankfurt plane laser beam: Position

the patient’s head so that the Frankfurt
plane is aligned with the Frankfurt plane
Mid-sagittal plane
laser beam.
laser beam
Frankfurt plane laser For proper positioning, adjust the way
beam in which the patient’s head is tilted by
Canine laser beam adjusting the height of the column using
the column up / down switch.
* The Frankfurt plane is a plane which
joins the infra-orbital point to the superior
border of the external auditory meatus.

C. Canine laser beam: Have the patient smile to properly position the canine
laser beam on the center of the patient’s canine tooth. Rotate the thumb wheel,
located under the patient support rest, forward or backward to properly align the
laser.

Adjusting lever for the

Frankfurt plane laser

Adjusting lever for the canine laser

Completing Patient Positioning

A. After confirming patient positioning and beam alignment, adjust the temple
supports to fit snugly on both sides of the patient’s head using the temple
support wheel. The temple support wheel is located at the front of the patient
support rest.

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B. Click the Ready button on the GUI or touch screen after the patient has been
properly positioned. No X-Ray will be emitted at this point. The rotating unit will
then move into position for imaging.

3. Proceed to section 6.3: Initiating X-Ray Exposure.

6.2.3
TMJ Close Mode

You may scan a TMJ Close image subsequent to a TMJ

Open image. Guide the patient to close his / her lips for
TMJ Close imaging while maintaining the same position
used for TMJ Open imaging.
NOTE
The positions are the same for both modes, except for the
position of the lips.

A. Shortly after TMJ Open imaging has been completed, you will receive the
following message: “Do you want to take the TMJ Close image continuously?”
Press the OK button to capture a TMJ Close image.

B. For TMJ Close imaging, Have the

patient:

■■Close his/her mouth

■■Keep his/her tongue pressed against

Acanthion Point
his/her palate

■■Close his/her eyes

The top of the TMJ support must remain in

contact with the patient’s acanthion point
during exposure.

Ask the patient to remain still until scanning is complete.

C. The laser beams should be aligned in the same way as for TMJ Open
imaging.

D. Proceed to section 6.3: Initiating X-Ray Exposure.

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6.2.4
Sinus Mode

Positioning the Patient

A. Insert the chin support (Sinus) into the

receptacle on the equipment.

CAUTION

Disinfect the chin support using an

alcohol-based cleaning solution and
wipe away all residues with a dry
cloth before proceeding any further.

B. Loosen the Temple Supports by

turning the Temple Support Wheel at the
rear of the patient support table.

C. Guide the patient —facing the chin

Temple support wheel support — to the equipment. Have the
patient stand upright in the center of the
equipment.

D. Adjust the height of the equipment using the column up/down switch until the
patient’s chin rests comfortably on the chin support.

E. Ask the patient to:

■■ Stand upright
■■ Firmly grip the handle
■■ Lean his/her chest lightly against the equipment
■■ Position his/her feet slightly forward.

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F. Ask the patient to press his/her lips

against the chin support.

G. Ensure that the patient’s shoulders

remain level and that his/her neck is
relaxed. The cervical spine should be
straight and upright.

H. Have the patient:

■■Tilt his/her head back by 10-15°

■■Close his/her mouth

■■Keep his/her tongue pressed against

his/her palate

■■Close his/her eyes

Ask the patient to remain still until

scanning is completed.

To acquire the best image possible, ask the patient not to:

CAUTION -- Breathe or swallow saliva during image acquisition

-- Move during image acquisition

Aligning the Laser Beams

Clicking on the Confirm button after setting the parameters

for imaging will activate the three laser beams (Mid-sagittal
plane, Frankfurt plane and Canine) to facilitate patient
alignment.

NOTE The beams will disappear after 20 minutes or if the Ready

button is clicked. To turn the lasers on or off, click either

the icon on the touch screen or the icon on the

imaging GUI.

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Be careful not to project the laser beams directly into the

patient’s eyes as this could severely damage the patient’s
WARNING
vision.

A. Mid-sagittal plane laser beam:

Position the Mid-sagittal plane laser
Frankfurt plane laser
beam beam at the center of the patient’s face to
prevent magnifications of the left or right
Mid-sagittal plane side in the final image.
laser beam

B. Frankfurt plane laser beam: The

Canine laser beam
Frankfurt plane laser beam should cross
the tip of patient’s nose when the patient’s
head is tilted back 10-15 degrees.

You may adjust the Frankfurt plane laser beam by manually adjusting the
Frankfurt plane laser beam lever.

C. Canine laser beam: Have the patient

smile to properly position the canine laser
beam on the center of the patient’s canine
tooth.

Adjusting lever for the Rotate the thumb wheel, located under the
canine laser patient support rest, forward or backward
to properly align the beam.

Completing Patient Positioning

A. After confirming patient positioning and beam alignment, adjust the temple
supports to fit snugly on both sides of the patient’s head using the temple
support wheel. The temple support wheel is located at the front of the patient
support rest.

B. Click the Ready button on the PC or touch screen after the patient has been
properly positioned. At this point, X-Ray will not be emitted. The rotating unit
will move to position for imaging.

C. Proceed to section 6.3: Initiating X-Ray Exposure.

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6.3 Initiating X-Ray Exposure

The X-Ray exposure method and its sequences are the same for PANO
Standard and PANO Special modes. The example used in this manual is the
PANO Standard mode.

To emit the X-Ray, perform the following procedure.

If a problem occurs during image acquisition, press the

red emergency stop button to immediately stop all moving
parts and cut off all power to the equipment’s electrical
components. You may then safely release the patient from
the equipment.

To reset this button, turn it clockwise until it pops up.

WARNING

Emergency stop button

-- Do not operate the PC or the touch screen during

exposure. Failure to comply with this instruction may
cause the system to malfunction.
--
WARNING
-- The operator shall observe the X-Ray safety regulations
applicable to their area at all times during the operation
of this equipment.

If an emergency occurs during image acquisition, release

CAUTION the exposure switch to cease X-Ray emission.

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A. Leave the X-Ray room and close the door. The operator must visually
monitor the patient at all times during image acquisition.

B. Press and hold down the exposure switch until image acquisition is
complete.

During X-Ray irradiation, ensure that

Exposure indicator
light turns orange -- The LED lamp on top of the equipment
Orange: Exposure turns orange to indicate X-Ray emission.

-- The warning lamp outside the X-Ray

room turns on.

-- The announcement mode of either beep

or music is initiated, depending on the
set-up.

X-Ray ON -- The radiation symbol on the upper left

corner of GUI turns yellow to indicate
X-Rays are being emitted.

C. The image appears in real time on the imaging GUI.

CASE 1: Normal / AF

Normal / AF: Ex) 5 images view is set

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To display an image at a time on the screen, either one can be used: clicking
the radio button or scrolling the mouse wheel. When clicked on the Save
button, the current image is saved.

With AF feature enabled, the best image of the 2 or 5

images taken can be saved.

This option can be selected by the user from the settings

NOTE screen by following the process below: Settings ( )→
PANO / CEPH → Multi focusing setting: Select 2 or 5
images → Save

If, for a single image view, the automatic save as a default

is selected, the captured image will be saved automatically.
NOTE

CASE 2: Magic PAN

Two images are obtained, with each in the Magic PAN and Normal respectively.
You would click either button to compare them with each other.

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