Background and Aims: Overlapping of the proximal surfaces of posterior teeth in the panoramic radiography is a major concern. Therefore, an option has been developed in the panoramic unit of Planmeca Promax, namely improved interproximal mode. This mode causes lower horizental angle with the teeth contact region during the unit rotation decreasing overlapping of the panoramic images of the posterior teeth especially premolar teeth. The present study was done to compare the overlapping of posterior teeth using two techniques of improved interproximal panoramic program and standard panoramic.

Materials and Methods: In this diagnostic study, 32 patients requiring panoramic radiographies at their posterior teeth during their routine diagnosis and treatment process with the mean age of 27.3 years were participated. No patients showed crowding of posterior teeth or missed and restored posterior teeth. The participants' panoramic radiographies were randomly taken by two techniques of improved interproximal panoramic and standard panoramic using Planmeca Promax device. The overlapping of the panoramic images was blindly assessed by an oral radiologist. The overlapping in both techniques was reported by frequency and percentage. The comparisons were done by Chi-square test between two techniques and the odds ratio of overlapping was estimated using regression analysis.

Results: In standard panoramic techniques, 38.5% (148 contacts of 384 contacts) of the proximal surfaces overlapped while the overlapping of the proximal surfaces was observed in 18.8% (72 contacts of 384 overall contacts) in improved interproximal technique. Significant differences were noted between two techniques regarding overlapping (P<0.001). Also 66.4% and 39.1% of 4-5 teeth contacts overlapped in standard and improved techniques. The values were reported to be 39.1% and 12.5% in contacts of 5-6 teeth and 10.2% and 4.7% in the contacts of 6-7 teeth in both techniques, respectively. The overlapping odds ratio in improved technique as compared to standard techniques was 2.72 more. While the odds ratio of overlapping in the contact regions of 4-5 and 5-6 teeth was 16.4 and 4.61 as compared to the contact region of 6-7 teeth (all: P<0.001). The lower or upper jaw with the patients' mouth side did not significantly influence the overlapping of the proximal surfaces in both panoramic techniques.

Conclusion: Under the limitations of this study, improved interproximal panoramic significantly reduced the overlapping of proximal surfaces in the panoramic radiographies of posterior teeth as compared to the standard panoramic technique. Therefore, it can be used to detect proximal caries in the posterior teeth as a diagnostic tool. Using this option may affect other part of panoramic image which should be investigated in other research.