The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 24 , ISSUE 9 ( September, 2023 ) > List of Articles


A Study to Evaluate the Efficacy of Ultrasonography as a Diagnostic Screening Tool in Maxillofacial Fractures: A Prospective Study

Akshay Manakkattupadi Vijayan, Sachin Aslam Aslam, Roshni Abidha, Mathew Pynummoottil Cherian, Ayisha Moonnam Kandathil

Keywords : Computed tomography, Maxillofacial, Sensitivity, Specificity, Ultrasonography

Citation Information : Vijayan AM, Aslam SA, Abidha R, Cherian MP, Kandathil AM. A Study to Evaluate the Efficacy of Ultrasonography as a Diagnostic Screening Tool in Maxillofacial Fractures: A Prospective Study. J Contemp Dent Pract 2023; 24 (9):645-650.

DOI: 10.5005/jp-journals-10024-3564

License: CC BY-NC 4.0

Published Online: 13-10-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: The aim of the study was to estimate the diagnostic efficacy of high-resolution ultrasonography (USG) in the diagnosis of maxillofacial fractures. Materials and Methods: A descriptive diagnostic evaluation study was carried out on 30 patients with suspected maxillofacial fractures, out of which 26 were male (86.7%) and 4 were female (13.3%). After initial management, detailed clinical examinations were carried out and significant findings were noted. Computed tomography (CT) scans were performed in fracture-suspecting patients followed by USG examination which was done in a standardized pattern on both sides of the face. The result of USG was compared with the CT scan report. Result: Based on CT findings, 65 sites were found to be fractured, and this was considered the gold standard. Ultrasonography detected 58 fractures at these 780 sites, of which 54 were true fractures, while 4 were false-positive results. However, USG was not able to detect eleven fractures. The overall sensitivity and specificity of USG were 83.1% and 99%, respectively. The positive and negative predictive values were 93% and 98%, respectively. Conclusion: According to our study, it may be concluded that USG may be recommended as a diagnostic screening tool to detect superficial maxillofacial fractures. Clinical significance: Ultrasonography provides a safe, cost-effective, reliable, non-invasive, easily available, and portable imaging modality to screen for maxillofacial fractures.

  1. Singaram M, Vijayabla GS, Udhayakumar RK. Prevalence, pattern, etiology, and management of maxillofacial trauma in a developing country: a retrospective study. J Korean Assoc Oral Maxillofac Surg 2016;42(4):174–181. DOI: 10.5125/jkaoms.2016.42.4.174.
  2. Rowe LD, Miller E, Brandt–Zawadzki M. Computed tomography in maxillofacial trauma. Laryngoscope 1981;91(5):745–757. DOI: 10.1288/00005537-198105000-00007.
  3. Shah N, Bansal N, Logani A. Recent advances in imaging technologies in dentistry. World J. Radiol 2014;6(10):794–807. DOI: 10.4329/wjr.v6.i10.794.
  4. McCann PJ, Brocklebank LM, Ayoub AF. Assessment of zygomatico orbital complex fractures using ultrasonography. Br J Oral Maxillofac Surg 2000;38(5):525–529. DOI: 10.1054/bjom.2000.0501.
  5. Friedrich RE, Plambeck K, Bartel–Friedrich S, et al. Limitations of B-scan ultrasound for diagnosing fractures of the mandibular condyle and ramus. Clin Oral Investig 2001;5(1):11–16. DOI: 10.1007/pl00010679.
  6. Curry TS III, Dowdey JE, Murry RC. Ultrasound, in Christensen's Physics of Diagnostic Radiology, 4th edition. Philadelphia: Lea & Febiger, 1990, pp. 323–371.
  7. White S, Pharoah M. Advanced Imaging Modalities. Oral Radiology: Principles and Interpretation, 5th edition. St Louis: Mosby, 2004, pp. 245–264.
  8. Jenkins CN, Thuau H. Ultrasound imaging in assessment of fractures of the orbital floor. Clin Radiol 1997;52(9):708–711. DOI: 10.1016/s0009-9260(97)80037-2.
  9. Kremkau FW. Diagnostic Ultrasound: Principles and Instruments, 5th edition. Philadephia: WB Saunders, 1998.
  10. Joshi PS, Pol J, Sudesh AS. Ultrasonography: A diagnostic modality for oral and maxillofacial diseases. Contemp Clin Dent 2014;5(3):345–351. DOI: 10.4103/0976-237X.137942.
  11. Ihnatsenka B, Boezaart AP. Ultrasound: Basic understanding and learning the language. Int J Shoulder Surg 2010;4(3):55–62. DOI: 10.4103/0973-6042.76960.
  12. Akizuki H, Yoshida H, Michi KI. Ultrasonographic evaluation during reduction of zygomatic arch fractures. J Craniomaxillofac Surg 1990;18(6):263–266. DOI: 10.1016/s1010-5182(05)80428-7.
  13. Nezafati S, Javadrashid R, Rad S, et al. Comparison of ultrasonography with submentovertex films and computed tomography scan in the diagnosis of zygomatic arch fractures. Dentomaxillofac Radiol 2010;39(1):11–16. DOI: 10.1259/dmfr/97056817.
  14. Scarfe WC. Imaging of maxillofacial trauma: Evolutions and emerging revolutions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100(Suppl. 2):S75–S96. DOI: 10.1016/j.tripleo.2005.05.057.
  15. Cocco G, Ricci V, Villani M, et al. Ultrasound imaging of bone fractures. Insights Imaging. 2022;13(1):189. DOI 10.1186/s13244-022-01335-z.
  16. Shah AS, Kale T, Hattiholi V, et al. Diagnostic accuracy of ultrasonography verified with computed tomography for the diagnosis of maxillofacial fractures: A prospective study. J Oral Maxillofac Radiol 2022;10(2):40. DOI: 10.4103/jomr.jomr_13_22.
  17. Singh KS, Jayachandran S. A comparative study on the diagnostic utility of ultrasonography with conventional radiography and computed tomography scan in detection of zygomatic arch and mandibular fractures. Contemp Clin Dent 2014;5(2):166–169. DOI: 10.4103/0976-237X.132306.
  18. Nezafati S, Ghavimi M, Javadrashid R, et al. Comparison of accuracy of computed tomography scan and ultrasonography in the diagnosis of mandibular fractures. Dent Res J (Isfahan) 2020;17(3):225–230. PMID: 32774801.
  19. Rajeev A, Pai KM, Smriti K, et al. Diagnostic accuracy of ultrasonography in the assessment of facial fractures. Pesqui Bras Odontopediatria Clín Integr 2020;19:4832. DOI: 10.4034/PBOCI.2019.191.133.
  20. Nyland TG, Matton, JS, Herrgesell EJ, et al. Physical principles, instrumentation, and safety of diagnostic ultrasound, in Nyland TG, Mattoon JS, editors. Small Animal Diagnostic Ultrasound, 2nd edition. Philadelphia: WB Saunders, 2002, pp. 1–18.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.