The Open Dentistry Journal

ISSN: 1874-2106 ― Volume 14, 2020

Is Ultrasonography Efficient for the Detection of the Zygomatic Arch, Nasal Bone and Cartilage Fractures?

Amir Eskandarloo1, Atena karimi2, Abbas Shokri1, *, Jalal Poorolajal3, Mohammad Hosseinipanah4
1 Department of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
2 Department of Oral and Maxillofacial Radiology, Dental School, Kermanshah University of Medical Sciences, Kermanshah, Iran
3 Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
4 Department of Anatomical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran



The high incidence of nasal and zygomatic arch fractures highlights the need for an accurate imaging modality for their detection. The superimposition of structures is a major problem in conventional radiography. Ultrasonography is a low-cost imaging modality with a wide range of applications, that does not employ ionizing radiation. This study aimed to assess the efficacy of ultrasonography for the detection of the zygomatic arch and nasal bone fractures.

Materials and Methods:

This study was conducted on 16 sheep heads. Artificial fractures were created in some parts of the zygomatic arch, dorsum and lateral wall of the nose, and nasal cartilage. All sheep heads underwent Cone-Beam Computed Tomography (CBCT) to ensure the presence of a fracture. Next, the lateral nasal and submentovertex radiographs were obtained, and ultrasonography was performed with a 12-15 MHz linear probe. Ultrasonography and radiography were repeated after 1 week to assess their reproducibility by calculating the kappa coefficient. Data were analyzed using Stata 11 software and Chi-square test.


The specificity and sensitivity of ultrasonography ranged from 87% to 100%, and 50% to 75%, respectively. The specificity and sensitivity of radiography ranged from 87% to 100%, and 62% to 87%, respectively. The differences between the two imaging modalities were not statistically significant (p>0.05). The kappa coefficient ranged from 46% to 100% for ultrasonography and 44% to 87% for radiography.


Ultrasonography seemed useful for the detection of displaced bone and cartilage fractures. For non-displaced fractures, US is not recommended.

Keywords: Fracture, Radiography, Sonography, Zygomatic arch, Nasal bone, Ultrasonography.

Article Information

Identifiers and Pagination:

Year: 2020
Volume: 14
First Page: 178
Last Page: 183
Publisher Id: TODENTJ-14-178
DOI: 10.2174/1874210602014010178

Article History:

Received Date: 28/08/2019
Revision Received Date: 23/02/2020
Acceptance Date: 24/02/2020
Electronic publication date: 22/04/2020
Collection year: 2020

© 2020 Eskandarloo et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Dental Research Center, Department of Oral and Maxillofacial Surgery, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran; Tel: (19) 99455-8417;

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