Midmark® Extraoral Imaging System (EOIS) 2D Panoramic X-Ray: Quick Positioning Guide

Before You Begin

Prior to setting up a patient exam, ensure all cleaning and disinfection guidelines are followed between patients. Use protective barriers and sheaths on patient-contacting mechanisms, such as the bite guide and TMJ guide, according to office protocols.

Set Up the Exam

Follow these steps to prepare the workstation and imaging software:

Patient Table Setup

[Image Description: An image of the headpiece of a panoramic dental X-ray machine, showing the adjustable headrest, a bite guide slot, and a telescopic column.]

1. 05 Insert the head positioner and align it to the 2D position on the patient table. Insert the bite guide or TMJ guide onto the head positioner.
2. 06 Raise or lower the telescopic column to the approximate height of the patient.

Operator Panel Setup

[Image Description: A close-up of the control panel of the dental X-ray machine. It displays buttons for "PAN", "CEPH", "3D", and icons representing patient size/jaw shape. It also shows current settings like "74kV" and "8mA", and a "READY FOR PATIENT" status.]

1. 07 Select "PAN."
2. 08 Tap or scroll to select the study: Standard, Enhanced, TMJ, Incisors, or Bitewing.
3. 09 Select patient size and jaw shape.
4. 10 Review kV and mA presets.

Position the Patient

Guide the patient into the correct position using the following steps:

[Image Description: An image showing a patient positioned correctly against the dental X-ray machine's headrest and forehead guides, with their feet slightly apart and back tilted slightly.]

1. 11 Ask the patient to remove eyeglasses, jewelry, and bulky outer clothing (not shown).
2. 12 Adjust the height of the telescopic column to match the patient's height (not shown).
3. 13 Ask the patient to grasp the hand grips and place their feet in front of their shoulders, leaning slightly back.
4. 14 Ask the patient to place their forehead against the forehead guides and press the button to slide the bridge just above the patient's eyebrows (not shown).
5. 15 Instruct the patient to place their upper and lower incisors in the bite guide groove.
6. 16 For TMJ scans, the TMJ guide should press against the base of the nose and top of the lip.
7. 17 Ask the patient to straighten their back and neck and relax their shoulders (not shown).
8. 18 Make final adjustments so the patient's chin is slightly elevated away from their chest (not shown).
9. 19 Secure the forehead guides by gently turning the knob clockwise.

[Image Description: Two close-up images. The first shows the "Bite Guide" component, a plastic piece for the patient to bite on. The second shows the "TMJ Guide", a different component used for specific TMJ scans.]

Align the Positioning Lasers

Use the positioning lasers to ensure accurate alignment:

[Image Description: Three images illustrating laser positioning. The first shows a horizontal laser aligned with the Frankfort Plane, from the base of the patient's optical orbit to the top of the ear canal. The second shows a sagittal plane laser centered on the bridge of the patient's nose and passing through the center of their upper lip. The third shows a cuspid positioning laser aligned with the anterior edge of the cuspid teeth.]

1. 20 Place the Horizontal laser in the lowest position.
2. 21 Turn on the positioning lasers.
3. 22 Align the Horizontal laser to the Frankfort Plane, from the base of the patient's optical orbit to the top of the ear canal. Note: For bitewings, set the laser to be parallel to the patient's occlusal plane.
4. 23 Align the Midsagittal Plane laser so that it centers on the bridge of the patient's nose and passes through the center of their upper lip.
5. 24 Align the Cuspid Positioning laser by asking the patient to smile and moving the thumbwheel on the patient table until the laser aligns to the anterior edge of the cuspid teeth. Note: For bitewings, position the Cuspid laser on the first pre-molar.
6. 25 Instruct the patient to close their mouth (not shown).

Note: TMJ exams require two images, one with the mouth closed and one with the mouth open.

Take the Image

Capture the dental image following these steps:

[Image Description: A screenshot of the operator panel displaying a preview of a captured panoramic dental X-ray image. It shows scan parameters like Scan Time, mAs, KAP, and patient name, along with an "OK" button.]

1. 26 Press and hold the motion icon (▶️) until the "Ready to Acquire" green status indicator appears.
2. 27 Instruct the patient to swallow, place their tongue against the roof of their mouth, and remain as motionless as possible until the device stops moving (not shown).
3. 28 Press and hold the exposure switch during the entire scan.
4. 29 Verify the image preview on the operator panel is correct, then tap OK.
5. 30 Help the patient exit the device (not shown).

[Image Description: An image of a dental professional giving a thumbs-up gesture (?), indicating successful completion or readiness.]

Further Information

For more detailed information about how to perform a 2D dental X-ray, please refer to the Midmark Extraoral Imaging System User Guide at technicallibrary.midmark.com/WebSite/DentalImagingSeries.htm.