CHARACTERISTICS OF MAXILLOFACIAL INJURIES CAUSED BY MINE-EXPLOSIVE WEAPONS: BALLISTIC ASPECTS, COMPLICATIONS AND MODERN APPROACHES TO COMPREHENSIVE REHABILITATION

The full-scale war in Ukraine has led to an unprecedented increase in mine-blast injuries, a significant proportion of which involve the maxillofacial region. The combination of high kinetic energy, fragmentation effects, and thermal damage results in complex combined injuries requiring multistage reconstruction and long-term rehabilitation. Available literature provides fragmented data regarding the morphology of such injuries, associated complications, and optimal approaches to treatment, underscoring the need to systematize Ukrainian clinical experience and correlate it with global scientific evidence. The aim of the study. To comprehensively analyze current scientific data and clinical experience concerning mine-blast injuries of the maxillofacial region, including their ballistic characteristics, typical complications, and modern approaches to reconstruction and rehabilitation. Materials and methods. An analytical review of scientific publications from 2014 to 2025 was conducted using PubMed, Scopus, Web of Science, Google Scholar, and Ukrainian professional medical sources. The review included studies addressing the ballistics of explosive injuries, clinical characteristics of maxillofacial trauma, surgical treatment approaches, and contemporary rehabilitation technologies. Special attention was given to the clinical experience of Ukrainian military medical institutions. Scientific research. The article is an excerpt from the planned research work of the Department of Orthopedic Dentistry of Bukovinian State Medical University of the Ministry of Health of Ukraine “Etiopathogenetic aspects of rehabilitation of major dental diseases of the maxillofacial region” (state registration number 0121U109997). Bioethics. Conclusion of the Biomedical Ethics Committee of Bukovinian State Medical University (protocol No. 4 dated December 23, 2025). Results of the study. Mine-blast injuries of the maxillofacial region result from the combined effects of the blast wave, fragment penetration, tertiary acceleration forces, and quaternary thermal and toxic factors. The ballistic parameters fragment parameters-such as mass, velocity, and shape-determine the extent of tissue destruction, the number and configuration of wound channels, and the degree of contamination. The most characteristic injuries include: comminuted fractures of the upper and lower jaws, explosive bone defects, extensive soft-tissue loss, neurovascular damage, dental arch defects, and combined craniofacial trauma. Complications encompass purulent-inflammatory processes (osteomyelitis, phlegmon), secondary deformities, functional impairments of chewing, speech, and swallowing, persistent aesthetic defects, neuropathic disorders, and significant psychoemotional morbidity. Modern rehabilitation relies on a multidisciplinary approach involving staged surgical management, microvascular free-flap reconstruction, 3D surgical planning, patient-specific implants, orthopedic and orthodontic rehabilitation, speech therapy, and psychological support. Conclusions. Mine-blast injuries of the maxillofacial region represent one of the most challenging types of combat trauma to reconstruct. The ballistic characteristics of damaging elements largely determine the clinical course and the extent of reconstructive interventions required. Advanced technologies-such as 3D modeling, patient-specific implants, and microvascular flap techniques-significantly improve rehabilitation outcomes, yet require broader implementation and adaptation within the Ukrainian healthcare system. Future priorities include the standardization of treatment protocols, development of a national registry for maxillofacial blast injuries, and clinical evaluation of contemporary reconstructive techniques.