An audit of the quality of dental panoramic radiographs in the Orthodontic Unit, Klinik Pergigian Cahaya Suria

Juliza Lepi; Mohd Zambri  Mohamed Makhbul

doi:10.31436/ijohs.v7i2.509

Authors

Juliza Lepi Orthodontic Specialist Unit, Klinik Pergigian Tanjong Karang, Selangor, Ministry of Health, Malaysia.
Mohd Zambri Mohamed Makhbul Orthodontic Specialist Unit, Klinik Pergigian Cahaya Suria, Kuala Lumpur, Ministry of Health, Malaysia.

DOI:

https://doi.org/10.31436/ijohs.v7i2.509

Keywords:

dental panoramic radiographs, clinical audit, orthodontic quality improvement

Abstract

This audit aimed to assess the quality of dental panoramic radiographs in the Orthodontic Unit at Klinik Pergigian (KP) Cahaya Suria by evaluating adherence to radiographic standards, the proportion of diagnostically acceptable images, and the parameters that frequently failed to meet established criteria. A total of 192 pre-treatment panoramic radiographs were analysed, and obtained from two radiology units: Hospital A (28.65%) and Hospital B (71.35%). Each radiograph was assessed using a standardized checklist covering patient identification, exposure parameters, artifact prevention, anatomical structure visibility, and overall diagnostic acceptability based on a two-point grading system. Intra-examiner reliability was ensured through repeated assessments. Data analysis identified trends and areas requiring quality improvement. The audit revealed that 98.96% of the panoramic radiographs were diagnostically acceptable, exceeding the 90% benchmark. Artifact removal compliance was 99.48%, ensuring minimal diagnostic interference. Right/left marking was consistently present in all images. Key anatomical structures such as condyles (93.75%), sinus floor (91.15%), crestal bone (95.83%), and teeth/developing follicles (100%) were highly visible. However, mental foramen visibility was low (42.71%), indicating potential limitations in exposure settings and positioning. Documentation gaps were noted, with 0% age recording and 36.98% missing exposure values, impacting record-keeping and retrospective analysis. The findings indicate that the radiograph quality assessed is highly satisfactory, with most images meeting diagnostic standards. However, improvements are needed in mental foramen visualization, exposure parameter documentation, and record-keeping. Regular audits, staff training, and a quality assurance checklist are recommended to further enhance diagnostic accuracy and compliance with radiographic standards.

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