Can we accurately measure structures on a panoramic image?

• A. Yes
• B. No
• C. Sometimes
• D. Only for centered objects

Answer: (B)

Panoramic imaging is a 2D projection of a curved 3D structure captured as the X-ray source and detector rotate around the patient. This geometry creates nonuniform magnification and distortion across the image because objects at different depths from the focal trough are magnified differently. Because true size depends on distance from the focal plane, measurements taken on a panoramic image don’t correspond to actual dimensions. Even areas that appear near the center aren’t free from distortion, so overall accuracy isn’t reliable. In practice, precise measurements are obtained with intraoral periapical radiographs or 3D imaging (like CBCT) when needed.