Comparison of positioning errors on panoramic radiographs in Indonesian children, adults, and elderly patients

Introduction
Panoramic radiography is one of the most frequently used extraoral radiography techniques. Different anatomical structures and levels of understanding of instructions may differ in different age groups.

Objectives
To investigate the distribution of positioning errors on panoramic radiographs and their correlation between the age groups of children, adults, and the elderly.

Material and methods
This descriptive cross-sectional study used 495 panoramic radiographs from oral radiology medical records at a dental hospital. The inclusion criteria were 3 age categories; children (≤ 14 years), adults (15-59 years), and the elderly (≥ 60 years) selected by a consecutive sampling method. Pearson’s 2 catego­rical comparative statistical tests were performed for data analysis from more than 2 unpaired samples.

Results
Among the 3 age groups, the radiographs that had the most errors were the children’s age group, with 321 errors (37%), while the radiographs of adults and the elderly had 255 (29.4%) and 292 errors (33.6%), respectively. It was recorded that the spine not being in the upright position, improper positioning of the tongue, and moving during exposure were statistically significantly different between the children, adults, and the elderly (p < 0.05, Pearson’s 2 test).

Conclusions
The results of this study showed that the most common error in the 3 age groups was incorrect tongue position. In elderly patients, the position of the spine was the second most common error, while in children, it was moving during exposure.