Association between orocraniofacial trauma and dental injuries: A systematic review and meta-analysis

Orocraniofacial (OCF) trauma includes injuries to the oral cavity, cranial structures, and facial skeleton caused by road traffic accidents, interpersonal violence, falls, and other high-energy events. Dental injuries are an often underreported component of OCF trauma despite their important forensic value in victim identification, documentation of violence, and determination of cause of death.

This systematic review and meta-analysis was conducted in accordance with the PRISMA 2020 guidelines. Five electronic databases (PubMed, Scopus, Web of Science, ProQuest, and Cochrane Library) were searched from inception to March 2026 without language restrictions. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) and Risk of Bias 2 (RoB-2) tools. A random-effects meta-analysis was applied, and heterogeneity was quantified using the I² statistic.

Out of 1,860 records, 18 studies involving 46,247 participants across 12 countries met the inclusion criteria. The pooled prevalence of dental injuries in OCF trauma was 24.3% (95% CI: 19.8-29.1%), with substantial heterogeneity (I² = 81.2%). Crown fractures were the most common injury type (OR 2.09; 95% CI: 1.74-2.51). Interpersonal violence showed the strongest association (OR 2.61; 95% CI: 1.98-3.44). Male gender (OR 1.58) and individuals under 18 years (OR 1.45) were consistently associated risk factors. Maxillary anterior teeth accounted for 82.7% of injuries.

In conclusion, dental injuries are significantly associated with OCF trauma and hold substantial forensic importance. Routine dental examination should be integrated into trauma assessment and forensic investigations, with future research focusing on standardized classification systems and multicenter prospective studies.