Rehabilitation of patients with polytrauma of the maxillofacial region: modern approaches and challenges

Background. Due to the full-scale war in Ukraine, the number of maxillofacial polytrauma cases among the civilian population has significantly increased. These injuries are most commonly caused by explosions, shrapnel, and blunt trauma, resultingin severe damage to soft tissues and bones. In such circumstances, dental rehabilitation becomes a crucial component of comprehensive recovery – restoring chewing function, aesthetics, and psychological well-being. However, there are considerable challenges: lack of resources, absence of standardized protocols, and shortage of qualified specialists. Purpose – analyze and develop effective modern strategies for dental rehabilitation of patients with polytrauma of the maxillofacial region, adapted to modern realities. Materials and methods. The study included 96 civilian patients with combat-related maxillofacial trauma (2022–2024). They were divided into two groups: the main group (58 patients who received comprehensive rehabilitation) and the control group (38 patients who received only basic treatment). The comprehensive approach included: initial debridement, osteosynthesis, prosthodontics, dental implantation, as well as speech therapy and psychological support. Effectiveness was assessed clinically, radiographically, and through patient surveys (OHIP-14, VAS), using SPSS for statistical analysis. Results. The most common injuries were blast trauma (36.2%), shrapnel wounds (31%), and blunt injuries (22.4%). Frequent complications included mandibular fractures (65%), tooth loss (48%), and soft tissue injuries (39%). Patients in the main group (A) showed significantly better recovery in both function and aesthetics: restored masticatory function in 89% versus 52 in the control group (B); successful social reintegration in 76% vs. 41, respectively. Complication rates and pain levels were also significantly lower in group A. Key success factors included early rehabilitation, a multidisciplinary approach, modern technologies, and psychological support. Main challenges were insufficient funding, lack of standardized care pathways, and limited resources. Conclusions. Comprehensive dental rehabilitation during wartime not only restores function but also contributes to the social reintegration and dignity of the patient. The implementation of structured protocols, multidisciplinary cooperation, and advanced technologies should become a priority in Ukraine’s healthcare system both during the war and in the post-war recovery phase.