RELEVANT ASPECTS FOR THE DIAGNOSIS AND TREATMENT OF MANDIBULAR FRACTURES CAUSED BY FIREARM PROJECTILES: A LITERATURE REVIEW
DOI:
https://doi.org/10.36557/2674-9432.2026v5n7p779-803Palavras-chave:
Mandibular fractures. Gunshot wounds. Maxillofacial trauma. Diagnosis. Mandibular reconstruction.Resumo
Mandibular fractures caused by firearm projectiles are complex injuries that may result in comminution, bone loss, and soft tissue damage. This study aimed to review the main aspects related to the diagnosis and treatment of these injuries. A narrative literature review was conducted, prioritizing studies published between 2021 and 2026 in the PubMed/MEDLINE and SciELO databases. The findings indicate that clinical assessment combined with computed tomography is essential to determine fracture extent and guide treatment planning. Treatment should be individualized and may include conservative approaches, open reduction with rigid internal fixation, and, in extensive defects, mandibular reconstruction with a free fibula flap. Virtual surgical planning and three-dimensional technologies may also improve the precision of reconstructive procedures. It is concluded that the management of these fractures requires accurate diagnosis, individualized planning, and a multidisciplinary approach according to the extent of the injury and the patient's clinical condition.
Downloads
Referências
BENEDICT, Katherine C.; HORRIAT, Narges L.; MCINTYRE, Benjamin C. Free fibula flap mandibular reconstruction: a video demonstrating operative technique. Plastic and Reconstructive Surgery Global Open, v. 11, n. 11, e5380, 2023. DOI: 10.1097/GOX.0000000000005380. Available at: https://pubmed.ncbi.nlm.nih.gov/37928631/. Accessed on: May 12, 2026.
BOURN, Lynn et al. Managing low-velocity mandibular gunshot wounds: an institutional review and the "FLOSS" severity scoring system. Journal of Craniofacial Surgery, v. 36, n. 2, p. 518-522, 2025. DOI: 10.1097/SCS.0000000000010963. Available at: https://pubmed.ncbi.nlm.nih.gov/39651896/. Accessed on: May 19, 2026.
GARAJEI, Ata et al. Functional and esthetic outcomes of virtual surgical planning versus the conventional technique in mandibular reconstruction with a free fibula flap: a retrospective study of 24 cases. Journal of Cranio-Maxillofacial Surgery, v. 52, n. 4, p. 454-463, 2024. DOI: 10.1016/j.jcms.2024.01.018. Available at: https://pubmed.ncbi.nlm.nih.gov/38448334/. Accessed on: May 27, 2026.
KRISHNADAS, Arjun et al. Simplified virtual surgical planning method for reconstruction of secondary maxilla and mandibular defects using free bone flap. Journal of Maxillofacial and Oral Surgery, v. 22, suppl. 1, p. 105-109, 2023. DOI: 10.1007/s12663-023-01906-7. Available at: https://pubmed.ncbi.nlm.nih.gov/37041941/. Accessed on: Jun 8, 2026.
PANESAR, Kanvar; SUSARLA, Srinivas M. Mandibular fractures: diagnosis and management. Seminars in Plastic Surgery, v. 35, n. 4, p. 238-249, 2021. DOI: 10.1055/s-0041-1735818. Available at: https://pubmed.ncbi.nlm.nih.gov/34819805/. Accessed on: Jun 17, 2026.
ROCHA, Suellen Sombra da et al. Mandibular traumas by gunshot: a systematic review with meta-analysis and algorithm of treatment. British Journal of Oral and Maxillofacial Surgery, v. 59, n. 3, p. e99-e108, 2021. DOI: 10.1016/j.bjoms.2020.08.019. Available at: https://pubmed.ncbi.nlm.nih.gov/33678448/. Accessed on: Jun 29, 2026.
VILLARMÉ, Agathe et al. Impact of virtual surgical planning and three-dimensional modeling on time to surgery in mandibular reconstruction by free fibula flap. European Journal of Surgical Oncology, v. 50, n. 3, 108008, 2024. DOI: 10.1016/j.ejso.2024.108008. Available at: https://pubmed.ncbi.nlm.nih.gov/38359724/. Accessed on: Jul 11, 2026.
VINAYAHALINGAM, Shankeeth et al. Detection of mandibular fractures on panoramic radiographs using deep learning. Scientific Reports, v. 12, 19596, 2022. DOI: 10.1038/s41598-022-23445-w. Available at: https://pubmed.ncbi.nlm.nih.gov/36379971/. Accessed on: Jul 22, 2026.
ZANATA-PINHEIRO, Luiz Henrique et al. Mandible fracture: analysis of 50 surgical cases in a teaching hospital. Revista Brasileira de Cirurgia Plástica, v. 38, n. 4, e0783, 2023. DOI: 10.5935/2177-1235.2023RBCP0783-PT. Available at: https://www.scielo.br/j/rbcp/a/7ZkZf9d4myCLmNJZK9pFvwF/?lang=pt. Accessed on: May 16, 2026.
MICROSURGICAL mandibular reconstruction with osteocutaneous fibula flap, assisted by 3D model, in a trauma patient: case report. Revista Brasileira de Cirurgia Plástica, v. 36, n. 1, 2021. DOI: 10.5935/2177-1235.2021RBCP0014. Available at: https://www.scielo.br/j/rbcp/a/CFxt4s4DqHVt3HTj5STRdkr/. Accessed on: May 5, 2026.
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2026 Cecília Cruz Teles Menezes, Maria Eduarda Batista Henriques, Andreia Pires de Souza, Alessandra Arthuso Alves, Adhalida Zaira de Oliveira Gonçalves, Gabriel Calixto da Rocha, Anne Nicácio Cruz de Souza Mello, Maria Luiza Araújo França, Neurivania Lopes Sousa, Pedro Henrique Ribeiro da Silva
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Você tem o direito de:
- Compartilhar — copiar e redistribuir o material em qualquer suporte ou formato para qualquer fim, mesmo que comercial.
- Adaptar — remixar, transformar, e criar a partir do material para qualquer fim, mesmo que comercial.
- O licenciante não pode revogar estes direitos desde que você respeite os termos da licença.
De acordo com os termos seguintes:
- Atribuição — Você deve dar o crédito apropriado , prover um link para a licença e indicar se mudanças foram feitas . Você deve fazê-lo em qualquer circunstância razoável, mas de nenhuma maneira que sugira que o licenciante apoia você ou o seu uso.
- Sem restrições adicionais — Você não pode aplicar termos jurídicos ou medidas de caráter tecnológico que restrinjam legalmente outros de fazerem algo que a licença permita.
