Impact of COVID-19 on Maxillofacial Trauma Incidence at Vajira Hospital: A Retrospective Study (2018-2021)

Background: Maxillofacial injuries vary globally depending on social, cultural, and environmental factors. The coronavirus disease 2019 (COVID-19) pandemic has further contributed to global variations in maxillofacial injury incidence owing to precautionary restrictions. Objective: To investigate the impact of COVID-19 on maxillofacial fractures. Materials and Methods: The present study was a retrospective cohort study that analyzed the medical records of patients with maxillofacial fractures admitted to the Emergency Department, Vajira Hospital, Bangkok. The incidence, causes, and anatomical sites of fractures were compared between the pre-COVID-19, 2018 to 2019, and COVID-19 periods, in 2020 to 2021. Results: The present study included 749 patients with maxillofacial fractures. The analysis revealed a 15% decrease in the number of patients with maxillofacial fractures during the COVID-19 pandemic. Males were more affected than females in both periods. Traffic accidents remained the primary cause of injuries, while assault-related injuries decreased significantly. Nasal bone fractures were the most frequent, with a significant reduction in orbital fractures caused by assault (p=0.033) during the COVID-19 period. The incidence of isolated zygomatic arch and panfacial fractures caused by assault increased during the COVID-19 period (p=0.026 and 0.041, respectively). The incidence of mandibular fractures due to other causes was significantly higher (p=0.009). Conclusion: The COVID-19 pandemic had led to significant changes in daily life in Thailand. Understanding the characteristics of patients with maxillofacial trauma provides valuable insights into prevention and management strategies, particularly during prolonged infectious disease outbreaks such as COVID-19 and potential future incidents.