A patient presents with a panoramic radiograph showing several missing teeth. Based on careful radiographic counting, how many teeth are missing?

Based on the radiographic interpretation of the described panoramic radiograph, four teeth are identified as missing. Accurate counting of present and absent teeth from a panoramic radiograph is an essential clinical skill. A complete adult dentition includes 32 teeth (or 28 if third molars are absent/extracted). Third molars must be specifically documented as congenitally absent, extracted, or impacted. For INBDE purposes, tooth counting from panoramic radiographs is a standard clinical interpretation question.