Computed tomography versus standard radiography in the assessment of fractures of the mandible.

Twenty-nine fractures of the mandible were studied by standard radiographs and axial computed tomographic scans (hard copy). Independent reviewers analyzed each study in a blinded, non-paired fashion. When radiographic diagnostic sensitivities were compared on the basis of known surgical findings, the plain films were found to have a higher diagnostic sensitivity (89%) than the hard copy computed tomograms (64%). This difference occurred primarily with images of nondisplaced fractures in posterior portions of the mandible, and is likely the result of tomographic orientation and volume averaging. Though computed tomography has emerged as the standard diagnostic test in evaluating intracranial and maxillofacial trauma, this study demonstrates that computed tomographic scanning alone is inadequate in excluding nondisplaced fractures of the posterior mandible.