Magnetic resonance imaging in dental, oral and maxillofacial trauma: A systematic review

This systematic review evaluates the current literature on state-of-the-art radiation-free MRI techniques for managing dental, oral, and maxillofacial trauma, comparing their diagnostic performance to conventional X-ray-based imaging. Two reviewers conducted an investigation using the PICOS search strategy across multiple databases, including MEDLINE, EMBASE, BIOSIS, Web of Science, Cochrane Library, LILACS, and BBO Dentistry. Twenty-nine studies were included: 12 on orbital trauma, 10 on condylar, subcondylar, or TMJ trauma, five on mandibular fractures, and one each on temporal bone and dental trauma. MRI was performed at post-traumatic, postoperative, or both stages. Despite variability in scan parameters, field strengths, and coil configurations, the results highlight MRI's growing potential in trauma assessment. CT-like and Black Bone MRI sequences enable simultaneous visualization of hard and soft tissues at trauma sites, providing diagnostic insights comparable to X-ray-based techniques. However, despite their superior soft-tissue assessment, they remain less effective at depicting intricate bony pathoanatomical conditions. This diagnostic approach can improve the long-term benefit-to-risk ratio, particularly for younger, radio-sensitive patients requiring repeated imaging and long-term follow-up. However, a modality- and protocol-oriented approach is essential to balance clinical conditions, radiation exposure, and diagnostic accuracy and efficiency, to ensure optimal patient outcomes in comprehensive trauma management.