MANDIBULAR AND MAXILLARY FRACTURES: SURGICAL APPROACHES AND ADVANCES IN RECONSTRUCTIVE MANAGEMENT

Abstract

Maxillofacial trauma is one of the most significant challenges in contemporary surgical practice, responsible for substantial functional and aesthetic morbidity among affected individuals. Mandibular and maxillary fractures represent a significant portion of these traumas, demanding therapeutic approaches that integrate anatomical precision, functional restoration, and aesthetic recovery (Mancilla et al., 2025; Saurabh et al., 2023). These injuries are frequently associated with traffic accidents, interpersonal assaults, and falls, reflecting not only biomechanical factors but also social and economic contexts that influence their incidence and severity (Fang et al., 2023). The mandible, due to its prominent and vulnerable anatomical position, is one of the most frequently fractured facial structures, while the maxillary complex presents anatomical particularities that make its treatment equally challenging (Tabatabaee et al., 2021). The correct reconstruction of these fractures aims to restore occlusion, masticatory function, and facial harmony, preventing sequelae such as malocclusion, asymmetry, and temporomandibular dysfunction (Bhushan et al., 2022). In this context, the appropriate therapeutic choice—between closed reduction techniques and Open Reduction with Internal Fixation (ORIF)—should be based on individualized anatomical, functional, and clinical criteria. The advent of digital technologies has promoted significant advances in maxillofacial surgery. The use of virtual planning, three-dimensional modeling, and 3D printing, associated with the application of artificial intelligence techniques for diagnosis and surgical planning, has revolutionized the reconstructive management of complex fractures (Chen et al., 2022; Hung et al., 2023). These innovations allow for greater operative predictability, reduced surgical time, and superior aesthetic and functional results, reflecting the continuous technical and scientific improvement in the field. Given this scenario, a comprehensive and up-to-date analysis of the different treatment modalities for mandibular and maxillary fractures is justified, as well as the technological advances that have transformed oral and maxillofacial surgical practice. The study of these aspects is essential for the development of more effective, safe, and individualized therapeutic protocols, capable of minimizing complications and optimizing the patient's rehabilitation process. Thus, this chapter aims to review and discuss the main surgical approaches employed in the treatment of mandibular and maxillary fractures, highlighting the reconstructive advances and the most recent technological contributions. It also seeks to emphasize the importance of integrating scientific knowledge, technical skill, and technological innovation as fundamental pillars for excellence in oral and maxillofacial surgical practice.

DOI: https://doi.org/10.56238/edimpacto2025.093-005