Persistent Dominance of Road Traffic Accidents in Maxillofacial Trauma Across South Asia: A Systematic Review and Meta-Analysis.

BACKGROUND

Maxillofacial trauma represents a major public health burden in South Asia, where road traffic accident (RTA) remains the predominant cause of injury. However, evidence regarding the etiological distribution of maxillofacial trauma across the region remains fragmented, limiting the development of targeted preventive strategies. This study aimed to synthesize the available evidence on the etiology of maxillofacial trauma in South Asia from 1995 to 2025, with emphasis on etiology and associated fracture patterns.

MATERIAL AND

METHODS

A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. PubMed, EMBASE, and Google Scholar were searched for the studies published between 1995 and 2025. A random-effects model was used to estimate the pooled prevalence. Heterogeneity was assessed using the I2 and τ2 statistics. Data synthesis was executed in R software, calculating pooled prevalence via forest plots and temporal trends through meta-regression. Sub-group analysis was performed to assess heterogeneity.

RESULT: A total of 74 studies comprising 93,123 patients were included, of which 69 were eligible for quantitative synthesis. RTAs were identified as the predominant etiology of maxillofacial trauma, with a pooled prevalence of 0.65 (95% CI: 0.60-0.69) followed by fall injury 0.14 (95% CI: 0.12-0.17) and interpersonal violence 0.11 (95% CI: 0.09-0.13). Zygomaticomaxillary complex (ZMC) and parasymphysis fractures were the most frequently reported injury pattern, with a marked male predominance of 5.5:1 across studies. Meta-regression demonstrated a non-significant temporal trend in RTA-related trauma over the study period. Substantial heterogeneity was present among studies, likely reflecting regional differences in infrastructure, socioeconomic conditions, and enforcement of traffic safety regulations.

CONCLUSION

In conclusion, RTA remains the principal contributor to maxillofacial trauma in South Asia, imposing a substantial burden on the healthcare system. The government should strengthen road safety regulations and ensure strict enforcement of traffic laws to reduce the burden of these injuries.