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. 2022 Jun 5;12(6):934.
doi: 10.3390/jpm12060934.

Dental Management of Maxillofacial Ballistic Trauma

Edoardo Brauner  1   2 , Federico Laudoni  1 , Giulia Amelina  1 , Marco Cantore  1 , Matteo Armida  1 , Andrea Bellizzi  1 , Nicola Pranno  1 , Francesca De Angelis  1 , Valentino Valentini  1   3 , Stefano Di Carlo  1   2
Affiliations

Dental Management of Maxillofacial Ballistic Trauma

Edoardo Brauner et al. J Pers Med. .

Erratum in

Abstract

Maxillofacial ballistic trauma represents a devastating functional and aesthetic trauma. The extensive damage to soft and hard tissue is unpredictable, and because of the diversity and the complexity of these traumas, a systematic algorithm is essential. This study attempts to define the best management of maxillofacial ballistic injuries and to describe a standardized, surgical and prosthetic rehabilitation protocol from the first emergency stage up until the complete aesthetic and functional rehabilitation. In low-velocity ballistic injuries (bullet speed <600 m/s), the wound is usually less severe and not-fatal, and the management should be based on early and definitive surgery associated with reconstruction, followed by oral rehabilitation. High-velocity ballistic injuries (bullet speed >600 m/s) are associated with an extensive hard and soft tissue disruption, and the management should be based on a three-stage reconstructive algorithm: debridement and fixation, reconstruction, and final revision. Rehabilitating a patient with ballistic trauma is a multi-step challenging treatment procedure that requires a long time and a multidisciplinary team to ensure successful results. The prosthodontic treatment outcome is one of the most important parameters by which a patient measures the restoration of aesthetic, functional, and psychological deficits. This study is a retrospective review: twenty-two patients diagnosed with outcomes of ballistic traumas were identified from the department database, and eleven patients met the inclusion criteria and were enrolled.

Keywords: dental rehabilitation; fixed implant-supported prosthesis; gunshot injuries; high-velocity ballistic wounds; low-velocity ballistic wounds; maxillofacial ballistic injuries; reconstructive surgery.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A 41-year-old female patient wounded by a low-velocity injury weapon. (a) Before prosthetic treatment; (b) after prosthetic treatment.
Figure 2
Figure 2
(a) Radiography imaging before prosthetic rehabilitation; (b) Radiography imaging after implant surgery.
Figure 3
Figure 3
Intraoral view: (a) temporary resin removable prosthesis; (b) after a fornix depth surgery; (c) implant surgery; (d) final implant-retained prosthesis.
Figure 4
Figure 4
A 29-year-old male patient wounded by a high-velocity injury weapon. (a) Before prosthetic treatment; (b) after prosthetic treatment.
Figure 5
Figure 5
(a)CT scan before reconstruction surgery and prosthetic rehabilitation; (b) 3D CT scan after reconstruction surgery with osteomyocutaneous free fibula flap; (c) CT scan after placement of six implants.
Figure 6
Figure 6
Intraoral view: (a) before treatment; (b) dental implant placed; (c) dental implant placed after a fornix depth; (d) final implant supported prosthetic rehabilitation.
Figure 7
Figure 7
A 31-year-old male patient wounded by a high-velocity injury weapon. (a) Before prosthetic treatment; (b) after prosthetic treatment.
Figure 8
Figure 8
(a) 3D imaging before prosthetic treatment; (b) Rx imaging after implant surgery. Three-dimensional, (3D).
Figure 9
Figure 9
Intraoral view: (a) before prosthetic treatment; (b) temporary resin removable prosthesis; (c) a titanium base screwed on implants; (d) final implant supported prosthetic rehabilitation.
Figure 9
Figure 9
Intraoral view: (a) before prosthetic treatment; (b) temporary resin removable prosthesis; (c) a titanium base screwed on implants; (d) final implant supported prosthetic rehabilitation.
Scheme 1
Scheme 1
Multidisciplinary and multistep management of maxillofacial ballistic trauma.
See this image and copyright information in PMC

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