The scattering of violence: A review of the global epidemiology and characteristics of maxillofacial firearm wounds.

BACKGROUND

Maxillofacial surgery frequently faces the permanent and catastrophic impacts of firearm injuries, an alarming scenario due to rising mortality and morbidity rates, representing both global and individual losses.

OBJECTIVES

The main objective of this study was to outline and synthesize the epidemiological profile and trends in the global incidence of firearm-related maxillofacial injuries.

METHODS

A scoping systematic review was conducted, including observational studies, case series, and case reports published up to September 2025, retrieved from PubMed and Google Scholar, using the combination of the terms "maxillofacial injuries," "gunshot wounds," "firearms," "ballistic injuries," and "epidemiology."

RESULTS

A total of 29 articles and mortality data from the World Health Organization (WHO) database were included. There were certain limitations in the global analysis of firearm-related mortality rates due to the scarcity of information. The average death rate from violence was higher in American countries compared to countries at war (p < 0.01), and it was not possible to establish significant correlations between firearm mortality and most demographic variables. A moderate negative correlation was observed between GDP and mortality rates in war contexts (ρ = -0.55, p < 0.05).

CONCLUSION

Greater transparency in national reporting is necessary to establish a more robust global epidemiological profile. Conversely, the negative impact of wars on national economies and violence in American countries is evident, and strict firearm access, control, and distribution laws are one potential strategy to combat this growing epidemic.