Systematic Review and Meta-analysis of the Pattern, Distribution, Etiology, and Treatment of Maxillofacial Injuries From Different Geopolitical Zones in Nigeria

Abstract Purpose: This study aimed to provide a nationwide survey of maxillofacial injuries pattern, distribution, etiology, and treatment based on Nigeria’s geopolitical zones. Methods: This systematic review and meta-analysis included all cross-sectional, cohort, case-control and randomized controlled studies published between 2004 and 2019 (16 years). Comparisons were made between different age groups, gender, site of maxillofacial injury, associated injuries, and treatment across geopolitical zones in Nigeria: southwest(SW), southsouth(SS), southeast(SE), northwest(NW), north central(NC) and northeast(NE). Proportion meta-analysis using the generic inverse variance method, risk ratio effect measure, and random effects model was conducted. Results: A total of 35 studies including 4,472 patients from four geopolitical zones across Nigeria (SW, SS, SE and NW) were included in this review. Age range was 0.3 to 90 years. Highest male to female ratio reported was 30:1. Road traffic crash (RTC) was the major risk factor for maxillofacial injuries (3.10, 95% CI, 2.34 – 4.10), and motorcycle crash was second (0.44; 95% CI, 0.29 – 0.66). Other aetiologic factors were assault (0.28; 95% CI, 0.19 – 0.40), fall (0.06; 95% CI, 0.03 – 0.11), sports injuries (0.03; 95% CI, 0.02 – 0.05) and others (0.04; 95% CI, 0.02 – 0.09). Conclusions and relevance: RTC, motorcycle crash and assault constituted the most important factors for maxillofacial injuries in Nigeria. The result of this study highlights the importance of improved road safety measures and maintenance of law and order.