Background: Maxillofacial injuries are a frequent occurrence in emergency clinical settings, posing diagnostic challenges that require both rapid and accurate assessment to facilitate appropriate treatment planning. Traditionally, conventional radiographs have served as the first-line imaging modality for evaluating facial trauma. However, the introduction of three-dimensional computed tomography (3D CT) has provided an alternative diagnostic tool, offering enhanced visualization of complex anatomical structures and potentially greater diagnostic accuracy. This systematic review aimed to critically evaluate and compare the diagnostic effectiveness and clinical utility of conventional radiographs versus 3D CT in assessing maxillofacial trauma. Methods: A systematic search was carried out using Google Scholar and PubMed to explore the comparative diagnostic performance of advanced imaging modalities—such as multidetector CT (MDCT), cone-beam CT (CBCT), and lateral cephalograms—against conventional radiographs for evaluating maxillofacial trauma and anatomical structures. Initially, 10,739 articles were retrieved using broad search terms including “maxillofacial trauma,” “3D CT,” “CBCT,” “orthopantomogram,” and “diagnostic accuracy.” Filters were then applied to limit the results to studies published between 2020 and 2025, resulting in 2,986 articles. After excluding review articles and case reports, and applying criteria to include only English-language, original human studies, a final selection of 3 relevant articles was made. Results: Findings across the selected studies consistently demonstrated the enhanced diagnostic value of 3D imaging techniques compared to traditional 2D radiographs. In trauma cases, multidetector CT and CBCT provided more detailed visualization of fracture lines, displacement, and sinus involvement. One study highlighted that 3D reconstructions offered clearer insight into maxillary and mandibular fractures than axial or sagittal slices alone. Another study utilized CBCT-based cephalograms to assess sinus morphology, revealing statistically significant differences in maxillary sinus volume between male and female patients, with potential applications in forensic identification. These advanced imaging tools not only improved sensitivity but also offered greater measurement accuracy and anatomical clarity. Discussion: Overall, this review supports the clinical utility of MDCT and CBCT as superior diagnostic options in the assessment of maxillofacial injuries and structural variations. Compared to conventional radiographic methods, three-dimensional imaging delivers clearer, more accurate visualizations, aiding in both clinical diagnosis and forensic applications. Their precision in detecting complex fractures and anatomical differences positions them as the preferred imaging choice in contemporary dental and maxillofacial practice.
Bokhari et al. (Mon,) studied this question.