Population ageing has resulted in a growing number of older adults presenting with traumatic oral and facial injuries. Improvements in healthcare have increased life expectancy, allowing many individuals to remain active well into later life. Consequently, falls, road traffic accidents, and other traumatic events continue to contribute substantially to oral and maxillofacial injuries among older people.1 Traumatic defects involving the oral cavity and facial structures may affect the mandible, maxilla, teeth, tongue, lips, and surrounding soft tissues.2 Such injuries often impair mastication, swallowing, speech, facial appearance, and social interaction. The presence of chronic systemic diseases, osteoporosis, frailty, diabetes mellitus, and delayed wound healing further complicates rehabilitation in elderly patients.3

Modern rehabilitation has evolved considerably with advances in reconstructive surgery, implant dentistry, digital surgical planning, computer-aided design and manufacturing, and multidisciplinary rehabilitation programs. Despite these developments, successful outcomes depend on careful patient selection, individualized treatment planning, and coordinated postoperative care.4

To evaluate rehabilitation strategies and functional outcomes among older patients with traumatic oral and facial defects.

This cross-sectional study conducted at a tertiary referral hospital for teaching scientific writing and research methodology. The study included 120 patients aged 65 years and older who received treatment for traumatic oral and maxillofacial defects between January and December 2025 after obtaining the ethical approval # ERC-1Z352. Patients were selected based on eligibility criteria, including a documented history of traumatic oral or facial defects, completion of rehabilitation treatment, and availability of six-month follow-up data. Patients with pathological fractures, congenital craniofacial anomalies, malignancy-related defects, or incomplete clinical records were excluded from the dataset. Demographic information, including age, sex, smoking status, and medical history, was collected. Clinical variables included the cause of trauma, type of oral or facial defect, rehabilitation modality, and postoperative functional outcomes. Functional recovery was evaluated by improvements in mastication, speech, swallowing, and patient satisfaction with facial appearance. Quality of life was assessed using a standardized questionnaire administered before rehabilitation and six months after treatment. The primary outcome of the study was successful functional rehabilitation. Secondary outcomes included improvements in mastication, swallowing, speech, facial aesthetics, and quality-of-life scores following rehabilitation. The dataset was analyzed using IBM SPSS Statistics version 27. Continuous variables were expressed as mean ± standard deviation, whereas categorical variables were summarized using frequencies and percentages. Comparisons of quality-of-life scores before and after rehabilitation were performed using a paired t-test. Logistic regression analysis was conducted to identify factors associated with successful rehabilitation. Statistical significance was considered at a p-value of less than

A total of 120 patients were included. The mean age was 74.2 ± 6.8 years. Male patients accounted for 60.0% of the study population, while females represented 40% (Table 1). Falls were the leading cause of injury (48.3%), followed by road traffic accidents (26.7%) (Table 2). Mandibular fractures were the most frequently observed injuries (Table 3). Open reduction and internal fixation was the most common treatment approach (Table 4). At six months, substantial functional improvements were observed (Table 5). Mean quality-of-life scores increased from 42.6 ± 11.4 before rehabilitation to 71.8 ± 10.2 after treatment (p < 0.001) (Table 6,7).

Table 1: Demographic Characteristics

Table 2: Causes of Trauma

Table 3: Types of Defects

Table 4: Rehabilitation Strategies

Table 5: Functional Outcomes

Table 6: Quality-of-Life Scores

Table 7. Factors Associated with Successful Rehabilitation

The present study demonstrated that multidisciplinary rehabilitation strategies resulted in favorable functional and quality-of-life outcomes among older adults with traumatic oral and facial defects. Falls were identified as the most common cause of injury, mandibular fractures represented the predominant defect, and open reduction with internal fixation was the most frequently performed treatment. Furthermore, implant-supported prosthetic rehabilitation and digital surgical planning were associated with improved rehabilitation outcomes, while diabetes mellitus negatively influenced recovery.

Falls accounted for nearly half of all traumatic injuries in the present study. This finding is consistent with previous investigation reported by Sharma et al. (2024)5 that falls have become the leading cause of maxillofacial trauma among older adults because of age-related reductions in muscle strength, impaired balance, visual impairment, polypharmacy, and osteoporosis. Several authors Jeyaraj et al. (2018)6 and Jimson et al. (2021)7 and have suggested that the increasing proportion of elderly individuals worldwide has shifted the epidemiology of facial trauma from high-energy injuries toward low-energy fall-related injuries. These observations emphasize the importance of fall-prevention strategies as an essential component of geriatric healthcare.

Mandibular fractures were the most frequently encountered traumatic defects in this study. Similar findings have been reported by Shiraishi et al. (2020)8 clinical investigations, where fractures of the mandibular body, angle, and condyle constituted the majority of facial fractures requiring surgical intervention. The anatomical prominence of the mandible and its exposure during facial impact make it particularly susceptible to injury. In elderly patients, decreased bone mineral density and age-related cortical bone thinning may further increase the risk of mandibular fractures following relatively minor trauma.9 Open reduction and internal fixation was the most commonly utilized rehabilitation strategy in the present study. This observation agrees with contemporary maxillofacial trauma literature, which recognizes rigid internal fixation as the standard treatment for displaced mandibular and maxillary fractures because it restores anatomical alignment, provides stable fixation, and allows early functional rehabilitation.10-12 Early mobilization is particularly beneficial in older patients, as prolonged immobilization may contribute to nutritional deterioration, muscle wasting, and reduced quality of life.13

Patients rehabilitated with implant-supported prostheses demonstrated higher odds of successful functional recovery than those receiving conventional prosthetic treatment. Previous reports have similarly shown that implant-supported rehabilitation improves prosthesis stability, masticatory efficiency, speech, phonetics, and patient satisfaction after traumatic tooth and jaw loss.11-14 A recent case series demonstrated excellent implant survival, stable prostheses, improved mastication, and high patient satisfaction following implant-supported rehabilitation of complex maxillofacial trauma. Likewise, a systematic review concluded that implant-supported prosthetic rehabilitation represents an effective treatment option for restoring occlusion and oral function following traumatic maxillofacial injuries, although additional high-quality clinical studies remain necessary. Digital surgical planning was also independently associated with successful rehabilitation. The increasing application of virtual surgical planning, three-dimensional imaging, computer-aided design/computer-aided manufacturing (CAD/CAM), and three-dimensional printing has transformed maxillofacial reconstruction during the past decade. These technologies facilitate accurate preoperative planning, improve reconstruction of complex anatomical defects, reduce operative time, and enhance prosthetic precision. Recent publications have further demonstrated that digital implant planning contributes to predictable functional and aesthetic outcomes while improving communication among surgeons, prosthodontists, and dental technicians.15,16

Substantial improvements were observed in mastication, swallowing, speech, and facial appearance six months after rehabilitation. Similar improvements have been reported in previous studies evaluating comprehensive oral rehabilitation following traumatic maxillofacial injuries. Restoration of oral function not only improves nutritional intake but also contributes to clearer speech, enhanced facial aesthetics, greater self-confidence, and improved social reintegration. These findings reinforce the concept that successful rehabilitation extends beyond anatomical reconstruction and should focus on restoring overall quality of life.17 Quality-of-life scores increased significantly after rehabilitation, reflecting the combined benefits of surgical reconstruction, prosthetic rehabilitation, and supportive multidisciplinary care. Previous studies have consistently demonstrated significant improvements in oral health-related quality of life following successful prosthetic rehabilitation, particularly when stable implant-supported prostheses are provided. Improvements in facial appearance and oral function often reduce anxiety, social isolation, and psychological distress experienced after traumatic facial injuries.18

Diabetes mellitus emerged as a negative predictor of successful rehabilitation in the present study. This finding is biologically plausible because diabetes has been associated with delayed wound healing, impaired angiogenesis, increased susceptibility to infection, and compromised bone remodeling.19 Consequently, diabetic patients frequently require more intensive perioperative management and prolonged follow-up to optimize healing and reduce postoperative complications.

This study demonstrates the format of a scientific manuscript evaluating rehabilitation strategies for traumatic oral and facial defects in older adults. The findings illustrate how multidisciplinary rehabilitation, advanced reconstructive techniques, implant-supported prostheses, and digital surgical planning may improve functional recovery and quality of life.

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