Ultrasonography in Oral and Maxillofacial Infections: A Scoping Review

Abstract

Maxillofacial infections are complex clinical conditions that can progress rapidly and extend into deep fascial spaces. Although computed tomography remains the reference imaging modality, ultrasonography has emerged as a promising alternative due to its accessibility, low cost, and lack of ionizing radiation. The aim of this review was to analyze and synthesize the available scientific evidence on the diagnostic and therapeutic role of ultrasonography in maxillofacial infections. A scoping review was conducted following the PRISMA-ScR guidelines and the methodological frameworks of Arksey and O’Malley and the Joanna Briggs Institute. A systematic search was conducted in PubMed, Scopus, and Web of Science for studies published between 2000 and May 9, 2026. The PubMed search strategy was: ("Ultrasonography"[Mesh]) AND ((("Focal Infection, Dental"[Mesh]) OR (maxillofacial infection)) OR (facial space infection)). Primary studies evaluating the diagnostic and/or therapeutic use of ultrasonography in maxillofacial infections were included. Eighteen studies involving a total of 787 participants were included. Most studies assessed odontogenic infections and superficial facial space infections. Ultrasonography was  useful for differentiating cellulitis from abscesses, assessing lesion extent, and guiding minimally invasive drainage procedures. However, limitations were reported in the assessment of deep fascial spaces due to interference from bone and air. The use of Point-of-Care Ultrasound (POCUS) demonstrated effectiveness in hospital and emergency care settings. Ultrasonography appears to be a valuable complementary tool in the management of maxillofacial infections, particularly for superficial infections and minimally invasive procedures. However, methodological heterogeneity and operator dependency limit definitive conclusions about its diagnostic and therapeutic accuracy.