THE ROLE OF 3-DIMENSIONAL COMPUTED-TOMOGRAPHY IN THE MANAGEMENT OF MAXILLOFACIAL BONE-FRACTURES

The findings of three-dimensional computed tomography (3DCT) and two-d imensional computed tomography (2DCT) with helical CT scanning were co mpared for 21 patients with maxillofacial bone fractures. The results of this study suggest that the 3DCT evaluation can be divided into 3 g roups. The first group, in which 3DCT is superior to 2DCT, includes se vere complicated midface fractures, for example, tripod fractures and complicated maxillary bone fractures, The second group, in which 3DCT is equal to 2DCT, includes simple fractures, for example, nasal bone f ractures and isolated zygomatic fractures. In this group, patients and their families could easily understand the nature of the fracture and clinical course shown by 3DCT as compared with conventional X-ray and 2DCT, The third group, in which 3DCT is inferior to 2DCT, includes bl owout fractures, Although 3DCT does not provide additional information in blowout fractures, helical scanning permits clear observation of m ultiplanar images without artifacts arising from metal prostheses by e xcluding lower slices during image reconstruction, We conclude that 3D CT provides useful information, especially in regard to the extent of complex fracture lines, as in tripod fractures.