Facial injuries from World War I war wounds have had a destructive effect on bone tissue and soft tissue. The gunshot wounds were not only the result of the projectiles of ammunition, but the effects of their explosion ruptured from the bone tissue, and much of that bone debris was converted into new projectiles, which erupted in funnel form in all directions, shredding the soft tissue.
The Germans entered World War I without any surgical response to the war's casualties. German military doctors were traumatized by oral surgery in war due to their previous experience in the Franco-Prussian, Balkan, and Russo-Japanese wars. Photographs taken by the military medical services have revealed the brutal anatomy of oral surgery.
The principles of oral surgery had not been altered in any of the wars. As the war expanded, oral surgery responded like a battlefield ruse. Obviously, the trauma was to a narrow area of the face, but oral surgery, specializing in a narrow framework, had to respond with an entirely new operation. The treatment of war traumatized jaw fractures applied a combination of surgery and dentistry. Treatment of fractured jaws was handled by orthodontics and dental treatments such as bridges. Orthodontics also required plastic surgery of the face. Facial expressions and masticatory functions were aided. Early orthodontic appliances were replaced by mechanical appliances.
However, modern weapons with increased destructiveness no longer caused just simple destruction, but most serious shattering, depending on the impact and distance. In many cases, bone tissue was crushed like pulverized sugar. In many cases, the whole thing was torn apart like rubble. Even when all or most of the mandible was covered with soft tissue, the crushed material went missing. The soft and bony tissues of the wound were accompanied by disfiguring deformities due to their ability to regenerate. The sparse, white bone tissue was gradually covered with soft tissue. The missing areas were formed by grafting, i.e., overplanted bone and soft tissues. The soft tissue damage affected the face and other parts of the disfigured deformity, even after repairing the immediate area of the mouth.
