Maxillofacial Bone Fractures in Children and Adolescents in Saudi Arabia: A Systematic Review

Facial injuries, including maxillofacial trauma (MFT), are common in children and adolescents due to their age and bone maturation stage. Children's injuries are less common than adults' due to parental supervision and the flexibility of the facial bone. Causes of maxillofacial bone fractures (MFBF) vary based on socioeconomic, cultural, and environmental factors. Management of MFBF in children and adolescents should consider their growth and development stage. A systematic review is needed to understand the prevalence, pattern, and distribution of MFBF in Saudi Arabia. This systematic review aimed to identify papers on MFBF in children and adolescents in Saudi Arabia using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. The search strategy involved searching electronic databases like PubMed/Medline, Web of Science, and Ebsco. The review included full-text original research papers, with inclusion criteria including English publications, human studies, and no restrictions on sample size, gender, date, or language. The selection process involved screening titles and abstracts, evaluating full texts, and identifying relevant studies. Data extraction involved two authors individually assessing selected studies. The PRISMA flow diagram of the literature search revealed that 26 papers were identified, of which 15 remained after excluding duplicates. After screening titles and abstracts, 10 articles were removed, and five papers were assessed for eligibility. Four papers met the inclusion criteria for the systematic review. The studies examined 1447 patients for the presence of MFBF in different regions. The majority of MFBF were caused by falls and road traffic accidents (RTAs) in children and adolescents. Mandibular fractures were the most common, followed by maxillary fractures. The majority of patients had tooth/teeth avulsions, followed by tooth luxation and crown fractures. Only one study described investigation methods for MFBF diagnosis. The systematic review reveals a high prevalence of MFBF among children and adolescents in Saudi Arabia, primarily due to falls and RTAs. The mandible is the most frequently fractured bone, and many children have concomitant teeth involvement. To reduce MFBF, effective initiatives and parental awareness strategies are recommended.