Moreover, the settings on panoramic radiograph machines are predetermined by the manufacturer, which can introduce variability in image accu­racy based on the patient’s head size and age, thereby affecting the quality of images of the maxillary and mandibular bones. While pan­oramic radiographs expose patients to less radia­tion than a full-mouth series of intraoral radiographs, they are not without a certain level of radiation exposure. It is essential to consider the cumulative effect of repeated radiographs, particularly for patients requiring frequent imag­ing, and clinicians must always follow the ALARA (As Low As Reasonably Achievable) principle to minimize radiation exposure. For comprehensive and precise TMJ evaluation, pan­oramic radiography has limitations in fully assessing the complex structures of the TMJs affected by conditions like degenerative joint dis­eases, internal derangements, and congenital anomalies. It is unable to provide a detailed and accurate view of the condyles in the fossa or effectively detect specic arthritic changes or abnormal outlines of the condyles, necessitating advanced imaging techniques like CBCT scans for a more comprehensive assessment [8, 11, 12]. Although panoramic radiography can be useful for detecting symmetrical or asymmetrical rela­tionships of the mandible, indicating abnormal growth of the condyle or idiopathic condylar resorption [10], it offers limited diagnostic value for the TMJ complex and other orofacial pain conditions. Its contribution in assisting with the diagnosis of orofacial pain is minimal unless spe­cic pathologies are present, leading to the con­clusion that panoramic radiography should only be used as a screening image and/or considered a last resort when other imaging modalities are unavailable.