Study	Research Aim	Participants	Method	Summary of Findings
Theme One: CBCT for Dentoalveolar Fractures
Long et al., 2014 [18]	To determine the diagnostic accuracy of CBCT for tooth fractures in vivo	Meta-analysis; 12 studies included	Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) used to assess quality of included studies	The pooled prevalence of tooth fractures in patients with clinically suspected but peri-apical radiography undetected tooth fractures was 91%. CBCT has a high diagnostic accuracy for tooth fractures. Caution with negative test results for endodontically treated teeth.
Sha et al., 2022 [19]	To compare the efficacy of periapical; radiography and CBCT for diagnosis of trauma to the anterior maxillary dentoalveolar region in children and adolescents	190 patients (120 males and 70 females) mean age: 11.1 years (range: 6–17 years)	Retrospective observational study. Images of patients who underwent both periapical radiography and CBCT between January 2016 and January 2020. Pairwise comparison between the receiver operating characteristic curves were performed for diagnosis of crown fractures, root fractures, alveolar bone fractures, and periapical radiolucencies.	CBCT was significantly superior to periapical radiography for the diagnosis of root fractures, alveolar fractures, and luxations and tooth resorption (p < 0.5). No significant difference between diagnosis of crown fractures and periapical radiolucencies (p > 0.5).
Bernardes et al., 2009 [20]	To compare 2D images with CBCT when diagnosing root fractures in the general practice setting	20 patients with suspected root fractures	Included patients who were submitted to examination by periapical radiography and CBCT; two professionals examined images according to pre-established scores.	CBCT was better than conventional radiography in the diagnosis of root fractures.
Chavda et al., 2014 [21]	To determine whether there is a difference in the in vivo diagnostic accuracy of digital radiography and CBCT in the detection of vertical root fracture	21 unsalvageable teeth from 20 patients with vertical root fracture	Digital radiograph and CBCT images compared with visual inspection of extracted tooth under a microscope.	DR and CBCT showed similar poor sensitivity (0.16 and 0.27, respectively), but high specificity (0.92 and 0.83). No statistical difference.
Theme 2: CBCT for Mandibular Fractures
Kaeppler et al., 2013 [28]	To determine the clinical efficacy of CBCT for suspected mandibular fractures and to evaluate whether findings would lead to a change in management	164 patients with suspected mandible fracture (231 sites) but equivocal clinical and 2D radiograph findings	Images were interpreted by oral and maxillofacial surgeons and treatment decisions based on pre and post-imaging were compared. Linear regression analyses were performed.	For 4.33% of sites (n = 10), no fractures were identified. For 63.2% of sites (n = 146), suspected diagnosis was confirmed on CBCT. Additional fracture identified in 17.785% (n = 41) and additional infractures in 14.72% (n = 34). Treatment plan altered in 9.52% of sites (n = 22).
Orhan et al., 2021 [32]	To investigate whether panoramic radiography and lateral skull projection images with lower radiation dose can be used instead of CBCT in the diagnosis of vertical condylar fractures	15 fresh cadaver mandibles with 30 condyles with vertical fractures created	Each condyle was imaged with panoramic, LSP, and CBCT.	CBCT detected fractures in 100% of cases and was superior to conventional techniques.
Viveka et al., 2023 [34]	To estimate the probable post-operative nerve injury in CBCT images	Observational study; 55 consecutive participants with a mandibular fracture between March 2021 and August 2022	Preop CBCT to estimate post-operative probable nerve dysfunction. Nerve function assessed with brush directional stroke test, two point discrimination, and sharp and blunt test.	CBCT provides additional information on the position of the mandibular canal. Risk factors include fracture line near the nerve or diversion of the course of the nerve. CBCT was 49.15% accurate in predicting post-operative nerve injury.
Theme 3: CBCT for Midface Fractures
Brisco et al., 2014 [42]	Comparison of the image quality and dosimetry data for CBCT of patients with suspected orbital fractures with similar data from 3 different conventional multi-slice CT techniques	10 patients CBCT (15 cm FOV) 10 trauma patients conventional CT		Quality of CBCT images of the orbits comparable to multi-slice CT, regardless of X-ray tube variables when displayed in bone windows. Poorer soft tissue contrast due to scattered radiation, although imaging of the extraocular muscles and optic nerve close to that of conventional CT of the sinuses or facial bones. Retrobulbar haemorrhage not identified on CBCT.
Roman et al., 2016 [43]	Evaluate the reliability on specific multi-planar CBCT reconstruction in orbital floor fractures	93 trauma patients CBCT examination	2 radiologist assessment of axial, coronal, and sagittal sections and also oblique coronal and sagittal sections evaluating the location of orbital fractures, size, displacement, involvement of infraorbital foramen, herniation of fat or muscle, and type of fracture.	CBCT offered good-quality images compared with bone window sections of medical CT. Higher detectability when using reformatted CBCT sectioning. Detection and herniation superior on CBCT oblique reconstructed images. In pure coronal view, displacement and migration measurable in less than half of cases, whereas in reformatted oblique, coronal detection in almost all cases. Good inter-observer agreement. Not a direct comparison of CBCT with CT due to ethical implications of double exposure.
Thiele, 2018 [44]	Investigating the feasibility of using CBCT data to design and generate customised implants for patients requiring craniomaxillofacial reconstruction		CBCT data used to generate 62 implants for 51 consecutive patients between January 2015 and December 2017.	In all cases, implants were well fitted and no implant-related complications were detected.
Rozema et al., 2018 [48]	To assess the diagnostic reliability of low dose medical CT vs. CBCT	Unilateral ZMC fractures in 4 out of 6 fresh, frozen human cadaver head specimens	Blind; 16 radiologists and 8 OMFS surgeons performed randomised image assessments.	ZMC fractures correctly diagnosed in 90.3% (n = 130) assessments. Dose reduction did not reduce the diagnostic reliability of MDCT and CBCT for ZMC fractures.
Theme Four: Intraoperative CBCT
Heiland et al., 2005 [49]	Assessment of the adequacy of intraoperative CBCT	14 patients undergoing surgical treatment for ZMC fractures	CBCT dataset generated and axial, coronal, and sagittal reconstructions evaluated by 5 examiners assessing 6 defined criteria.	Secondary reconstructions available in 6 min. Because of the size of the datasets, assessment of symmetry of the malar projection proved difficult. Best-scoring results with regards to visualisation of fragment position, bony anchorage of screws and fitting of plates.
Pohlenz et al., 2009 [54]	Describe the first clinical application of CBCT with an integrated flat-panel detector for ZMC fractures	9 CBCT datasets of patients with a ZMC fracture were acquired intraoperatively using a mobile isocentric C-arm including a flat-panel detector	4 OMFS surgeons and 2 radiologists evaluated each dataset regarding noise, transition, and delineation of landmarks.	The size of the FOV increased to allow visualisation of the whole facial skeleton.
Singh et al., 2015 [56]	Describe the use of intraoperative CBCT C arm for ZMC malpositioning	1 case ZMC malpositioning in a patient with panfacial fractures	Case report	Intraoperative CT scan allowed for immediate revision; helpful in patients with panfacial fractures and distorted anatomical landmarks.
Alasraj et al., 2021 [57]	To determine how intraoperative CT affects the intraoperative revision rate	22 patients underwent 25 intraoperative scans	Retrospective study. Primary outcome variable: immediate revision rate. Secondary outcome: total scanning time.	50% required an intraoperative revision and 12.6% a repeat scan. Mean scanning time: 18.9 +/− 4.6 min. Highest rate of revisions in ZMC (63.6%). None of the patients required secondary corrective surgery.
Gander et al., 2018 [58]	Assess the use of intraoperative CBCT for determining intraoperative revision rate and need for additional reconstruction of the orbit	47 consecutive patients with simple or complex ZMC fractures	Retrospective analysis. Intraoperative CBCT (Xoran Technologies, Ann Arbor, MI, USA) was overlaid on preoperative image using iPlan software (Brainlab, Feldkirchen, Germany).	6/48 intraoperative revisions were necessary. Of these, 5/6 were comminuted fractures. In 7, patients the indication for orbital reconstruction was revised.
Cuddy et al., 2018 [59]	To quantify the effect of intraoperative CT on surgical decision making	161 patients, consecutive recruitment	Retrospective case series; level 1 trauma centre.	CT-directed revision rate: 31% orbital, 24% ZMC, 8% Le fort I, 23% Le fort II and III, 23% NOE, 13% mandible, and 0% frontal sinus.