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

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.