ORTHODONTIC CARE DELIVERY IN UKRAINE DURING MARTIAL LAW: CHALLENGES, CLINICAL RISKS, AND ADAPTATION STRATEGIES

Abstract

Introduction. The imposition of martial law in Ukraine has led to systemic transformations in the organization of healthcare delivery, resulting in reduced accessibility of the population to planned medical services, including dental care. Orthodontic treatment is inherently prolonged, multi-stage, and dependent on regular monitoring. Consequently, disruptions in scheduled visits due to patient displacement, resource constraints, and elevated psycho-emotional stress may adversely affect treatment outcomes and increase the risk of complications. Objective. To synthesize contemporary evidence regarding the prevalence of dentofacial anomalies in Ukraine with particular emphasis on regional data; to characterize the organizational and economic mechanisms of orthodontic care delivery under wartime conditions; to analyze the clinical consequences associated with interruptions of orthodontic treatment; and to identify potential strategies for adapting clinical practice through the implementation of telemonitoring, digital technologies, and crisis-resilient protocols. Materials and Methods. A narrative literature review was conducted using searches in PubMed, Scopus, and relevant national sources. Publications in the fields of orthodontics, public health, crisis medicine, and the organization of dental care were included. Evidence was synthesized concerning the epidemiology of dentofacial anomalies in Ukraine, the impact of war on healthcare accessibility, and adaptive modifications of clinical protocols. Results and Discussion. Findings from regional studies in Ukraine confirm a high prevalence of dentofacial anomalies among children and adolescents, generating a substantial demand for orthodontic treatment. The ongoing war has been accompanied by documented attacks on the healthcare system and disruptions in access to medical services, directly affecting the provision of planned orthodontic care. The principal clinical risks associated with treatment interruption include loss of biomechanical control over tooth movement, increased risk of enamel demineralization and periodontal complications, as well as reduced patient compliance. Promising adaptive approaches involve patient risk stratification, protocol simplification, extension of follow-up intervals with safety monitoring, and the integration of telemonitoring and digital tools. Conclusions. Under conditions of martial law, the orthodontic service in Ukraine requires the integration of clinical and systemic strategies, including ensuring continuity of treatment, standardization of management during forced interruptions, implementation of digital support systems, and consideration of psychosocial determinants.