Grillo Ricardo, Quinta Reis Bruno Alvarez, Brozoski Mariana Aparecida, Zindel Deboni Maria Cristina, Melhem-Elias Fernando
Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, São Paulo, Brazil.
Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, São Paulo, Brazil.
J Craniomaxillofac Surg. 2025 Aug;53(8):1052-1060. doi: 10.1016/j.jcms.2025.03.020. Epub 2025 Apr 13.
Ballistics has undergone significant evolution, shaping its role in both military and civilian contexts. This article explores the trajectory of ballistic advancements and their profound implications for maxillofacial surgery. From the early days of firearms in tenth-century China to the modern understanding of terminal ballistics, the study highlights how advancements in projectile technology have transformed injury mechanisms. Ballistic injuries, particularly in the head and neck regions, pose unique challenges, due to their complexity, often involving high-energy transfer and extensive tissue disruption. These injuries necessitate a multidisciplinary approach, incorporating ballistic principles into surgical planning to enhance outcomes. By examining 162 studies, including retrospective analyses, clinical trials, and ballistic research, this review identifies trends in ballistic trauma and its management. The findings reveal a shift in injury patterns, with firearm-related facial injuries decreasing, but exhibiting increased morbidity and mortality. The integration of knowledge on projectile dynamics, tissue response, and energy transfer empowers surgeons to anticipate complications, refine surgical techniques, and mitigate long-term sequelae. Advancements in ballistic technology have also influenced treatment protocols, emphasizing the need for interdisciplinary research and collaboration. Historical and modern scenarios, from the Battle of Thermopylae to conflicts in Lebanon and Ukraine, underscore the evolving nature of ballistic injuries. The study concludes that a comprehensive understanding of ballistics is essential for improving patient care in maxillofacial surgery, advocating for continued research to address emerging challenges and refine interventions for complex trauma cases.
弹道学经历了重大变革，塑造了其在军事和民用领域的作用。本文探讨了弹道学进步的轨迹及其对颌面外科的深远影响。从10世纪中国火器的早期发展到现代对终点弹道学的理解，该研究突出了弹丸技术的进步如何改变了损伤机制。弹道损伤，尤其是头颈部区域的损伤，因其复杂性而带来独特挑战，通常涉及高能量传递和广泛的组织破坏。这些损伤需要多学科方法，将弹道学原理纳入手术规划以提高治疗效果。通过审查162项研究，包括回顾性分析、临床试验和弹道学研究，本综述确定了弹道创伤及其管理的趋势。研究结果显示损伤模式发生了变化，与火器相关的面部损伤有所减少，但发病率和死亡率却有所上升。对弹丸动力学、组织反应和能量传递知识的整合使外科医生能够预测并发症、改进手术技术并减轻长期后遗症。弹道技术的进步也影响了治疗方案，强调了跨学科研究与合作的必要性。从温泉关战役到黎巴嫩和乌克兰的冲突等历史和现代场景，凸显了弹道损伤的不断演变的性质。该研究得出结论，全面了解弹道学对于改善颌面外科的患者护理至关重要，主张持续开展研究以应对新出现的挑战并完善对复杂创伤病例的干预措施。
