A mandibular series possess several disadvantages compared with an OPG such as superimposition of osseous structures, difficulty in placing the film perpendicular to the fracture, and presence of confusing spatial relationships. A mandibular series does not require the patient to be upright, remain motionless for an extend period, or cervical spine clearance like an OPG [31]. Although isolated mandibular fractures have often been accurately diagnosed using radiography techniques, notable limitations include fractures of the mandible condyle and subcondylar fractures having anterior 14 Imaging of Facial Trauma Following Primary Survey displacement, both of which are more easily demonstrated on CT [107,108]. In addition, an OPG can miss both nondisplaced and minimally displaced anterior fractures when there is overlap with the cervical spine [99,109]. A complex fracture may be mistaken for an isolated fracture if OPG is used initially [42]. An OPG can better visualize dental root fractures compared with CT, particularly when the fracture is located at an angle [31]. The use of OPG and mandibular series radiographs has become less favorable in emergency and trauma care settings [110]. Despite this fact, some authors have used radiographs for creating scoring systems for mandibular fractures for an objective and standardized assessment for the degree of severity of mandibular fractures [111]. associated cervical spine injuries [19]. Imaging of Facial Trauma Following Primary Survey High-velocity maxillofacial trauma and penetrating neck trauma are the most common causes of traumatic vascular injuries. Identification and treatment of these injuries should be swift because irreversible neurologic damage or death may occur. Occult neurovascular injury, carotid-cavernous fistula, or carotid transection can occur with severe facial fractures [62,63].
Imaging of Facial Trauma Following Primary Survey. A mandibular series possess several disadvantages compared with an OPG such as superimposition of osseous structures, difficulty in placing the film perpendicular to the fracture, and presence of confusing spatial relationships. A mandibular series does not require the patient to be upright, remain motionless for an extend period, or cervical spine clearance like an OPG [31]. Although isolated mandibular fractures have often been accurately diagnosed using radiography techniques, notable limitations include fractures of the mandible condyle and subcondylar fractures having anterior 14 Imaging of Facial Trauma Following Primary Survey displacement, both of which are more easily demonstrated on CT [107,108]. In addition, an OPG can miss both nondisplaced and minimally displaced anterior fractures when there is overlap with the cervical spine [99,109]. A complex fracture may be mistaken for an isolated fracture if OPG is used initially [42]. An OPG can better visualize dental root fractures compared with CT, particularly when the fracture is located at an angle [31]. The use of OPG and mandibular series radiographs has become less favorable in emergency and trauma care settings [110]. Despite this fact, some authors have used radiographs for creating scoring systems for mandibular fractures for an objective and standardized assessment for the degree of severity of mandibular fractures [111]. associated cervical spine injuries [19]. Imaging of Facial Trauma Following Primary Survey High-velocity maxillofacial trauma and penetrating neck trauma are the most common causes of traumatic vascular injuries. Identification and treatment of these injuries should be swift because irreversible neurologic damage or death may occur. Occult neurovascular injury, carotid-cavernous fistula, or carotid transection can occur with severe facial fractures [62,63].