Detection rate of dental trauma and maxillofacial injuries in high-energy polytrauma patients on total body CT: incidence and underestimation

全身CT对高能量多发伤患者牙外伤和颌面部损伤的检出率:发生率和低估

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Abstract

PURPOSE: The aim of our study was to assess the frequency and detection rate of dental trauma and maxillofacial injuries (DTMI) in high-energy polytrauma patients undergoing total-body computed tomography (TBCT) and to estimate how often they are correctly reported by the radiologists. METHODS: This retrospective study included 611 patients who underwent TBCT following high-energy trauma between July 2024 and February 2025. DTMI findings were analyzed based on initial radiology reports and retrospective image review. RESULTS: DTMI was identified in 124 of 611 patients (20.2%), of which only 76 cases (61%) were reported at admission. Dental trauma was significantly underreported (76% missed rate), with only 12 of 50 cases (24%) initially recognized. In contrast, maxillofacial injuries were detected in 75 of 97 cases (77,3%). Most DTMI-positive patients (82/124, 66%) had additional traumatic findings, including cranial or spinal injuries (33/124, 26.6%) and multi-district trauma (29/124, 23.4%). Only 20 patients (16%) presented with isolated facial trauma. A small subgroup (18/124, 14.5%) had DTMI with no other traumatic findings, suggesting possible oversight in the absence of overt injury. Underreporting rates were slightly higher during night shifts (55%) compared to daytime (48%), though not statistically significant (χ² = 0.654, p > 0.05). DTMI was more common in males (ratio 1.79:1). CONCLUSION: DTMI, especially dental trauma, is frequently underdiagnosed in the acute trauma setting. Improved detection may be achieved through dedicated imaging protocols, increased radiologists awareness, and AI-based support tools.

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